Atelectasis in the perioperative patient.
OBJECTIVE
To report the impact of atelectasis on perioperative outcomes. Atelectasis occurs in the dependent parts of the lungs of most patients who are anesthetized. Development of atelectasis is associated with decreased lung compliance, impairment of oxygenation, increased pulmonary vascular resistance and development of lung injury. Here, we examine the etiology, contributing factors, consequences, diagnosis and treatment of atelectasis.


RESULTS
Atelectasis describes the state of absent air in alveoli attributable to collapse, but recent findings suggest that alveoli are filled with foam and fluid. It is now known that atelectasis plays an important role beyond abnormal gas exchange and that prevention or reversal of atelectasis in some populations of postoperative patients may improve outcome.


CONCLUSIONS
Atelectasis in the presence of preexisting lung disease or limited cardiopulmonary reserve may have significant consequences. Increasing understanding of the underlying nature of atelectasis and its contribution to acute lung injury will improve our approach to the prevention and management of atelectasis.
Duggan
Michelle
M
Department of Anesthesia, Mayo General Hospital, Castlebar, Co. Mayo, Ireland.
Kavanagh
Brian P
BP
D000375:Aging / Q000502:physiology; D000758:Anesthesia; D000818:Animals; D006801:Humans; D010102:Oxygen Inhalation Therapy; D019990:Perioperative Care; D011187:Posture; D001261:Pulmonary Atelectasis / Q000209:etiology* / Q000628:therapy*; D011663:Pulmonary Surfactants; D014655:Vascular Resistance / Q000502:physiology
D011663:Pulmonary Surfactants