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Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review

Mechanical ventilation (MV) is still necessary in many surgical procedures; nonetheless, intraoperative MV is not free from harmful effects. Protective ventilation strategies, which include the combination of low tidal volume and adequate positive end expiratory pressure (PEEP) levels, are usually a...

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Autores principales: Fogagnolo, Alberto, Montanaro, Federica, Al-Husinat, Lou’i, Turrini, Cecilia, Rauseo, Michela, Mirabella, Lucia, Ragazzi, Riccardo, Ottaviani, Irene, Cinnella, Gilda, Volta, Carlo Alberto, Spadaro, Savino
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234365/
https://www.ncbi.nlm.nih.gov/pubmed/34208699
http://dx.doi.org/10.3390/jcm10122656
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author Fogagnolo, Alberto
Montanaro, Federica
Al-Husinat, Lou’i
Turrini, Cecilia
Rauseo, Michela
Mirabella, Lucia
Ragazzi, Riccardo
Ottaviani, Irene
Cinnella, Gilda
Volta, Carlo Alberto
Spadaro, Savino
author_facet Fogagnolo, Alberto
Montanaro, Federica
Al-Husinat, Lou’i
Turrini, Cecilia
Rauseo, Michela
Mirabella, Lucia
Ragazzi, Riccardo
Ottaviani, Irene
Cinnella, Gilda
Volta, Carlo Alberto
Spadaro, Savino
author_sort Fogagnolo, Alberto
collection PubMed
description Mechanical ventilation (MV) is still necessary in many surgical procedures; nonetheless, intraoperative MV is not free from harmful effects. Protective ventilation strategies, which include the combination of low tidal volume and adequate positive end expiratory pressure (PEEP) levels, are usually adopted to minimize the ventilation-induced lung injury and to avoid post-operative pulmonary complications (PPCs). Even so, volutrauma and atelectrauma may co-exist at different levels of tidal volume and PEEP, and therefore, the physiological response to the MV settings should be monitored in each patient. A personalized perioperative approach is gaining relevance in the field of intraoperative MV; in particular, many efforts have been made to individualize PEEP, giving more emphasis on physiological and functional status to the whole body. In this review, we summarized the latest findings about the optimization of PEEP and intraoperative MV in different surgical settings. Starting from a physiological point of view, we described how to approach the individualized MV and monitor the effects of MV on lung function.
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spelling pubmed-82343652021-06-27 Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review Fogagnolo, Alberto Montanaro, Federica Al-Husinat, Lou’i Turrini, Cecilia Rauseo, Michela Mirabella, Lucia Ragazzi, Riccardo Ottaviani, Irene Cinnella, Gilda Volta, Carlo Alberto Spadaro, Savino J Clin Med Review Mechanical ventilation (MV) is still necessary in many surgical procedures; nonetheless, intraoperative MV is not free from harmful effects. Protective ventilation strategies, which include the combination of low tidal volume and adequate positive end expiratory pressure (PEEP) levels, are usually adopted to minimize the ventilation-induced lung injury and to avoid post-operative pulmonary complications (PPCs). Even so, volutrauma and atelectrauma may co-exist at different levels of tidal volume and PEEP, and therefore, the physiological response to the MV settings should be monitored in each patient. A personalized perioperative approach is gaining relevance in the field of intraoperative MV; in particular, many efforts have been made to individualize PEEP, giving more emphasis on physiological and functional status to the whole body. In this review, we summarized the latest findings about the optimization of PEEP and intraoperative MV in different surgical settings. Starting from a physiological point of view, we described how to approach the individualized MV and monitor the effects of MV on lung function. MDPI 2021-06-16 /pmc/articles/PMC8234365/ /pubmed/34208699 http://dx.doi.org/10.3390/jcm10122656 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Fogagnolo, Alberto
Montanaro, Federica
Al-Husinat, Lou’i
Turrini, Cecilia
Rauseo, Michela
Mirabella, Lucia
Ragazzi, Riccardo
Ottaviani, Irene
Cinnella, Gilda
Volta, Carlo Alberto
Spadaro, Savino
Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review
title Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review
title_full Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review
title_fullStr Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review
title_full_unstemmed Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review
title_short Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review
title_sort management of intraoperative mechanical ventilation to prevent postoperative complications after general anesthesia: a narrative review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234365/
https://www.ncbi.nlm.nih.gov/pubmed/34208699
http://dx.doi.org/10.3390/jcm10122656
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