Perioperative lung injury.
Patients are at risk for several types of lung injury in the perioperative period. These injuries include atelectasis, pneumonia, pneumothorax, bronchopleural fistula, acute lung injury and acute respiratory distress syndrome. Anesthetic management can cause, exacerbate or ameliorate most of these injuries. Clinical research trends show that traditional protocols for perioperative mechanical ventilation, using large tidal volumes without positive end-expiratory pressure (PEEP) can cause a sub-clinical lung injury and this injury becomes clinically important when any additional lung injury is added. Lung-protective ventilation strategies using more physiologic tidal volumes and appropriate levels of PEEP can decrease the extent of this injury.
Slinger
Peter
P
University of Toronto, Department of Anesthesia, 3 EN, Toronto General Hospital, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada. peter.slinger@uhn.on.ca
D000818:Animals; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D019990:Perioperative Care / Q000379:methods*; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000517:prevention & control*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000517:prevention & control