Protective ventilation from ICU to operating room: State of art and new horizons

6Citations
Citations of this article
40Readers
Mendeley users who have this article in their library.

Abstract

The prevention of ventilator-associated lung injury (VALI) and postoperative pulmonary complications (PPC) is of paramount importance for improving outcomes both in the operating room and in the intensive care unit (ICU). Protective respiratory support includes a wide spectrum of interventions to decrease pulmonary stress–strain injuries. The motto ‘low tidal volume for all’ should become routine, both during major surgery and in the ICU, while application of a high positive end-expiratory pressure (PEEP) strategy and of alveolar recruitment maneuvers requires a personalized approach and war-rants further investigation. Patient self-inflicted lung injury is an important type of VALI, which should be diagnosed and mitigated at the early stage, during restoration of spontaneous breathing. This narrative review highlights the strategies used for protective positive pressure venti-lation. The emerging concepts of damaging energy and power, as well as pathways to per-sonalization of the respiratory settings, are discussed in detail. In the future, individualized approaches to protective ventilation may involve multiple respiratory settings ex-tending beyond low tidal volume and PEEP, implemented in parallel with quantifying the risk of VALI and PPC.

Cite

CITATION STYLE

APA

Kirov, M. Y., & Kuzkov, V. V. (2020, June 1). Protective ventilation from ICU to operating room: State of art and new horizons. Korean Journal of Anesthesiology. Korean Society of Anesthesiologists. https://doi.org/10.4097/kja.19499

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free