Perioperative Lung Injury

Abstract

Traditional patterns of mechanical ventilation with large (e.g., 10-12 mL/kg) tidal volumes and without positive end-expiratory pressure (PEEP) cause a subclinical injury in healthy lungs in proportion to the duration of ventilation. Perioperative acute lung injury becomes clinically important when injurious ventilation patterns are used in patients who have other concomitant lung injuries such as large pulmonary resection, cardiopulmonary bypass, or transfusion-related lung injury. Lung-protective patterns of mechanical ventilation, using more physiologic tidal volumes and appropriate PEEP, reduce the severity of this lung injury. A recent decrease in the incidence of lung injury after pulmonary resection is primarily due to a decrease in the frequency of pneumonectomies.