Theodore H. Stanley, M. D. Anesthesia and the Lung contains the Refresher Course manuscripts of the presentations of the 34th Annual Postgraduate Course in Anesthesiology which took place at The Cliff Conference Center in Snowbird, Utah, February 17-21, 1989. The chapters reflect recent advances in the diagnosis, pre-, intra-, and postoperative anesthetic management of patients with lung disease, presenting for pulmonary and non-pulmonary surgery. They also deal with ventilation-perfusion issues, the lung as a metabolic organ, the effects of anesthesia on pulmonary mechanics and pulmonary blood flow. In addition there are chapters that will focus around hypoxia; regional differences in the lung; pulmonary surfactant; recent advances in the understanding of pulmonary edema; high altitude disease; anesthesia and the control of breathing; recent developments in oximetry; instrumentation designed to measure pulmonary oxygen tension, P0 and PC0 trans­ 2 2 cutaneously; differential lung ventilation; reactive airways; septic shock; the adult respiratory distress syndrome and numerous aspects of ventilatory support. The purposes of the textbook are to 1) act as a reference for the anesthesiologists attending the meeting, and 2) serve as a vehicle to bring many of the latest concepts in anesthesiology to others within a short time of the formal presenta­ tion. Each chapter is a brief but sharply focused glimpse of the interests in anesthesia expressed at the conference.

Regional Differences in the Lung.- Regulation of the Pulmonary Circulation.- New Concepts in the Regulation of the Pulmonary Vasculature: Biochemical Activities of Endothelial Cells that influence Pulmonary Vascular Tone and Blood Flow.- Pathophysiology of Pulmonary Edema: Implications for Clinical Management.- Control of Breathing.- Pulmonary Surfacant: An Endogenous Mediator of Alveolar Stability and a Therapeutic Agent.- High Altitude Diseases.- Preparing the Patient with COPD for Surgery.- Anesthetic Influences on the Pulmonary Circulation.- Ventilation-Perfusion Mismatching During Anesthesia.- Anesthesia and Changes in Lung Volume.- Oximetry I: Nomenclature, History, Accuracy and Uses.- What is the Required Inspired Oxygen Consumption During Anesthesia?.- Postoperative Hypoxia.- The 1981 American Medical Research Expedition to Mt. Everest.- Effects of Anesthetics on Pulmonary Gas Exchange.- Oximetry II: Limitations and Effects on Other Monitors.- Anesthesia for Thoracic Surgery: Part I - Double-Lumen Tube Intubation.- Anesthesia for Thoracic Surgery: Part II - Management of One-Lung Ventilation.- Anesthetic Management of the Patient with Reactive Airways.- Differential Lung Ventilation.- Physiologic Effects of Raised Airway Pressure.- HFJV, PS, IRV, MMV, APRV, "New" Ventilatory Modes.- Adult Respiratory Distress Syndrome.- Hemodynamics and Therapy in ARDS.- Septic Shock.- Respiratory Mechanics in ICU Patients.- Dynamic Hyperinflation: Intrinsic PEEP and Its Ramifications in Patients with Respiratory Failure.- Why Intermittent Mandatory Ventilation (IMV) Fails?.- Weaning from Ventilatory Support.- ECMO: A View from the East.