title: Postoperative apnea, respiratory strategies, and pathogenesis mechanisms: a review.
abstract: Recovery from anesthesia is ideally routine and uneventful. After extubation, the recovering postoperative patient ought to breathe without supportive care or additional oxygenation. It has been demonstrated in previous studies that postoperative pulmonary complications are clinically relevant in terms of mortality, morbidity, and length of hospital stay. Compromised postoperative ventilation can be described as the condition in which the postoperative patient does not have satisfactory spontaneous ventilation support and adequate oxygenation. Causes of impaired ventilation, oxygenation, and airway maintenance can be mechanical, hemodynamic, and pharmacologic. This review describes prevalence and differential diagnosis, including co-morbidities of postoperative apnea. The physiological mechanisms of breathing and prolonged postoperative apnea are also reviewed; these mechanisms include influences from the brainstem, the cerebral cortex, and chemoreceptors in the carotid and aortic body. Causes of prolonged postoperative apnea and management are also discussed.
authors.affiliation: Department of Anesthesiology, Louisiana State University School of Medicine, Louisiana State University Health Science Center, 1542 Tulane Ave, New Orleans, LA 70112, USA. akaye@lsuhsc.edu
authors.forename: Alan D
authors.initials: AD
authors.lastname: Kaye
authors.forename: McKenzie Mayo
authors.initials: MM
authors.lastname: Hollon
authors.forename: Nalini
authors.initials: N
authors.lastname: Vadivelu
authors.forename: Gopal
authors.initials: G
authors.lastname: Kodumudi
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Kaye
authors.forename: Franklin Rivera
authors.initials: FR
authors.lastname: Bueno
authors.forename: Amir R
authors.initials: AR
authors.lastname: Baluch
mesh_terms: D000762:Anesthesia Recovery Period; D000818:Animals; D001049:Apnea / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D011184:Postoperative Period; D012119:Respiration