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Journal ArticleDOI

Pulmonary atelectasis: a pathogenic perioperative entity.

Michelle Duggan, +1 more
- 01 Apr 2005 - 
- Vol. 102, Iss: 4, pp 838-854
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TLDR
The authors discuss the effects and implications of atelectasis in the perioperative period and illustrate how preventive measures may impact outcome and the impact of atElectasis and its prevention in acute lung injury.
Abstract
Atelectasis occurs in the dependent parts of the lungs of most patients who are anesthetized. Development of atelectasis is associated with decreased lung compliance, impairment of oxygenation, increased pulmonary vascular resistance, and development of lung injury. The adverse effects of atelectasis persist into the postoperative period and can impact patient recovery. This review article focuses on the causes, nature, and diagnosis of atelectasis. The authors discuss the effects and implications of atelectasis in the perioperative period and illustrate how preventive measures may impact outcome. In addition, they examine the impact of atelectasis and its prevention in acute lung injury.

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Citations
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Management of One-lung Ventilation: Impact of Tidal Volume on Complications after Thoracic Surgery

TL;DR: While low (physiologically appropriate) VT is an important component of an LPV strategy for surgical patients during OLV, current evidence suggests that, without adequate PEEP, low VT does not prevent postoperative respiratory complications.
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Intraoperative recruitment maneuver reverses detrimental pneumoperitoneum-induced respiratory effects in healthy weight and obese patients undergoing laparoscopy.

TL;DR: RM combined with 10 cm H2O of PEEP improved EELV, respiratory mechanics, and oxygenation during pneumoperitoneum whereas PEEP alone did not.
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Lung protective strategies in anaesthesia

TL;DR: The effects of perioperative mechanical ventilation and its role in ventilator-induced lung injury are examined and lung protective ventilatory strategies to specific clinical situations such as cardiopulmonary bypass and one-lung ventilation are discussed.
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Effect of intraoperative high inspired oxygen fraction on surgical site infection, postoperative nausea and vomiting, and pulmonary function: Systematic review and meta-analysis of randomized controlled trials

TL;DR: In patients receiving inhalational anesthetics without prophylactic antiemetics, high FIO2 provided a significant protective effect against both nausea and vomiting, and does not increase the risk of postoperative atelectasis.
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Protective mechanical ventilation in the non-injured lung: review and meta-analysis

TL;DR: A systematic review of the scientific literature and a meta-analysis regarding the rationale of applying protective ventilatory strategies in patients at risk of ARDS in the perioperative period and in the intensive care unit (ICU) are performed.
References
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Journal ArticleDOI

Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.

TL;DR: In patients with acute lung injury and the acute respiratory distress syndrome, mechanical ventilation with a lower tidal volume than is traditionally used results in decreased mortality and increases the number of days without ventilator use.
Journal ArticleDOI

The acute respiratory distress syndrome

TL;DR: An overview of the definitions, clinical features, and epidemiology of the acute respiratory distress syndrome is provided and advances in the areas of pathogenesis, resolution, and treatment are discussed.
Journal ArticleDOI

Effect of a Protective-Ventilation Strategy on Mortality in the Acute Respiratory Distress Syndrome

TL;DR: As compared with conventional ventilation, the protective strategy was associated with improved survival at 28 days, a higher rate of weaning from mechanical ventilation, and a lower rate of barotrauma in patients with the acute respiratory distress syndrome.
Journal ArticleDOI

Ventilator-induced lung injury: lessons from experimental studies.

TL;DR: This paper presents experimental evidence for Increased Vascular Transmural Pressure Evidence for Alterations in Alveolar–Capillary Permeability Contributions of the Static and Dynamic Lung Volume Components to Ventilator-induced Edema High-volume Lung Edema Low Lung Volume Injury.
Journal ArticleDOI

Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial.

TL;DR: Mechanical ventilation can induce a cytokine response that may be attenuated by a strategy to minimize overdistention and recruitment/derecruitment of the lung, and these physiological improvements are associated with improvements in clinical end points.
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