title: Non-ventilatory approaches to prevent postoperative pulmonary complications.
abstract: This educational narrative review provides a summary of non-ventilatory strategies to prevent postoperative pulmonary complications (PPCs). It highlights patient- and procedure-related risk factors for PPCs that are non-modifiable, potentially modifiable, or well modifiable. Non-ventilatory strategies, mainly based on the modification of risk factors, play a key role in reducing PPCs. Non-modifiable risk factors, most importantly age, American Society of Anesthesiologists (ASA) class, and risk of the procedure, should be recognized and patients intensively screened for the potential to optimize other, potentially or well-modifiable, risk factors. Potentially modifiable risk factors, mainly comorbidities and the surgical approach, increase the risk of PPCs. Patient-related factors can be improved while procedure-related factors may be adapted in high-risk patients. Well-modifiable risk factors, mainly certain anesthesia techniques, for example, general anesthesia, intravenous opioids or liberal fluid management, and smoking or alcohol abuse, should be avoided as far as possible in order to prevent PPCs.
authors.affiliation: University Hospital Carl Gustav Carus, Department of Anesthesiology and Critical Care Medicine, Technische Universität Dresden, Fetscherstrasse, 74 01307 Dresden, Germany. Electronic address: andreas.gueldner@uniklinikum-dresden.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Güldner
authors.affiliation: University Hospital Carl Gustav Carus, Department of Anesthesiology and Critical Care Medicine, Technische Universität Dresden, Fetscherstrasse, 74 01307 Dresden, Germany.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Spieth
authors.affiliation: University Hospital Carl Gustav Carus, Department of Anesthesiology and Critical Care Medicine, Technische Universität Dresden, Fetscherstrasse, 74 01307 Dresden, Germany.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Gama de Abreu
mesh_terms: D000367:Age Factors; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D000776:Anesthesiology / Q000379:methods; D000818:Animals; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D012307:Risk Factors
keywords: analgesia; anesthesia; comorbidities; neuromuscular blockade; physiotherapy; postoperative pulmonary complications