Topic
Atelectasis
About: Atelectasis is a research topic. Over the lifetime, 4744 publications have been published within this topic receiving 101707 citations.
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TL;DR: Positive end-expiratory pressure was most helpful in combating atelectasis and hypoxaemia and Corticosteroids appeared to have value in the treatment of patients with fat-embolism and possibly viral pneumonia.
3,706 citations
TL;DR: Recommendations are to subclassify T1 into T1a, T1b, and T1c, and to group involvement of main bronchus as T2 regardless of distance from carina; to group partial and total atelectasis/pneumonitis as T1; to reclassify diaphragm invasion as T4; and to delete mediastinal pleura invasion as a T descriptor.
1,511 citations
TL;DR: Meta-analyses of randomized, control trials confirm that postoperative epidural pain control can significantly decrease the incidence of pulmonary morbidity and support the utility of epidural analgesia for reducing postoperativemonary morbidity but do not support the use of surrogate measures of pulmonary outcome as predictors or determinants of pulmonary mortality in postoperative patients.
Abstract: We performed meta-analyses of randomized, control trials to assess the effects of seven analgesic therapies on postoperative pulmonary function after a variety of procedures: epidural opioid, epidural local anesthetic, epidural opioid with local anesthetic, thoracic versus lumbar epidural opioid, intercostal nerve block, wound infiltration with local anesthetic, and intrapleural local anesthetic. Measures of forced expiratory volume in 1 s (FEV,), forced vital capacity (FVC), vital capacity (VC), peak expiratory flow rate (PEFR), Pao,, and incidence of atelectasis, pulmonary infection, and pulmonary complications overall were analyzed. Compared with systemic opioids, epidural opioids decreased the incidence of atelectasis (risk ratio [RR] 0.53, 95% confidence interval [CI] 0.33-0.85) and had a weak tendency to reduce the incidence of pulmonaryinfections (RRO.53,95% CIO.18-1.53) and pulmonary complications overall (RR 0.51, 95% CI 0.20-1.33). Epidural local anesthetics increased Pao, (difference 4.56 mm Hg, 95% CI 0.058-9.075) and decreased the incidence of pulmonary infections (RR 0.36,95% CI 0.21-0.65) and pulmonary complications overall (RR 0.58,95% CI 0.42-0.80) compared with systemic opioids. Intercostal nerve blockade tends to improve pulmonary outcome measures (incidence of atelectasis: RR 0.65,95% CI 0.271.57, incidence of pulmonary complications overall: RR 0.47, 95% CI 0X3-1.22), but these differences did not achieve statistical significance. There were no clinically or statistically significant differences in the surrogate measures of pulmonary function (FEV,, FVC, and PEFR). These analyses support the utility of epidural analgesia for reducing postoperative pulmonary morbidity but do not support the use of surrogate measures of pulmonary outcome as predictors or determinants of pulmonary morbidity in postoperative patients. Implications: When individual trials are unable to produce significant results, it is often because of insufficient patient numbers. It may be impossible for a single institution to study enough patients. Meta-analysis is a useful tool for combining the data from multiple trials to increase the patient numbers. These meta-analyses confirm that postoperative epidural pain control can significantly decrease the incidence of pulmonary morbidity.
1,019 citations
TL;DR: If the pattern of ventilation, by itself, may influence oxygenation during anesthesia and surgery, and the hypothesis that progressive pulmona...
Abstract: THE present study was undertaken to determine if the pattern of ventilation, by itself, may influence oxygenation during anesthesia and surgery. The hypothesis was examined that progressive pulmona...
688 citations
TL;DR: 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.
585 citations