Atelectasis during anesthesia: pathophysiology and treatment.
METHODS
The incidence of intraoperative pulmonary collapse is elevated in patients undergoing surgery under general anesthesia with muscle relaxation/paralysis. This complication is associated with worsening intraoperative gas exchange and, in some cases, the need for prolonged postoperative respiratory support. The objective of this report was to review the pathophysiological aspects of atelectasis during general anesthesia and possible therapeutic maneuvers that could prevent and treat this complication.


BACKGROUND
This review discusses the concepts about the incidence of intraoperative atelectasis, factors that influence their development, both mechanical and those related to mechanical ventilator settings during the surgery, diagnostic criteria, and strategies to prevent and treat this complication.


CONCLUSIONS
Understanding of the mechanisms related with the development of intraoperative pulmonary collapse, as well as its treatment, can contribute to reduce the incidence of postoperative pulmonary complications, the length of recovery and hospital costs.
Disciplina de Anestesiologia do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP. malbouisson@hcnet.usp.br
Luiz Marcelo Sá
LM
Malbouisson
Flávio
F
Humberto
Roseny dos Reis
Rdos R
Rodrigues
Maria José Carvalho
MJ
Carmona
José Otávio Costa Júnior
JO
Auler
D000758:Anesthesia / Q000009:adverse effects*; D006801:Humans; D001261:Pulmonary Atelectasis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy