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19 - Ventilation during General Anaesthesia

from Section 2 - Targeting Effects

Published online by Cambridge University Press:  03 December 2019

By
Lluís Gallart
Edited by
Pedro L. Gambús  and
Jan F. A. Hendrickx
Pedro L. Gambús
Affiliation:
Hospital Clinic de Barcelona, Spain
Jan F. A. Hendrickx
Affiliation:
Aalst General Hospital, Belgium
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Summary

Even though practices do differ geographically, general anaesthesia often involves some mode of mechanical ventilation different from normal spontaneous ventilation. This chapter will focus on the differences between these conditions, and describe the problems associated with artificial ventilation.

Type
Chapter
Information
Personalized Anaesthesia
Targeting Physiological Systems for Optimal Effect
 , pp. 271 - 284
Publisher: Cambridge University Press
Print publication year: 2020

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References

Druz, WS, Sharp, JT: Activity of respiratory muscles in upright and recumbent humans. J.Appl.Physiol.Respir.Environ.Exerc.Physiol. 1981; 51 (6): 1552–61.Google Scholar
Hedenstierna, G, Edmark, L: Effects of anesthesia on the respiratory system. Best.Pract.Res.Clin.Anaesthesiol. 2015; 29 (3): 273–84.Google Scholar
Froese, AB, Bryan, AC: Effects of anesthesia and paralysis on diaphragmatic mechanics in man. Anesthesiology. 1974; 41 (3): 242–55.Google Scholar
Tusman, G, Bohm, SH, Warner, DO, Sprung, J: Atelectasis and perioperative pulmonary complications in high-risk patients. Curr.Opin.Anaesthesiol. 2012; 25 (1): 1–10.Google Scholar
Bersten, AD, Kavanagh, BP: A metabolic window into acute respiratory distress syndrome: stretch, the “baby” lung, and atelectrauma. Am.J.Respir.Crit.Care.Med. 2011; 183 (9): 1120–2.Google Scholar
Slutsky, AS, Ranieri, VM: Ventilator-induced lung injury. N.Engl.J.Med. 2013; 369 (22): 2126–36.Google Scholar
Duggan, M, Kavanagh, BP: Pulmonary atelectasis: a pathogenic perioperative entity. Anesthesiology. 2005; 102 (4): 838–54.CrossRefGoogle ScholarPubMed
Chiumello, D, Carlesso, E, Cadringher, P, Caironi, P, Valenza, F, Polli, F, et al: Lung stress and strain during mechanical ventilation for acute respiratory distress syndrome. Am.J.Respir.Crit.Care.Med. 2008; 178 (4): 346–55.Google Scholar
Mead, J, Takishima, T, Leith, D: Stress distribution in lungs: a model of pulmonary elasticity. J.Appl.Physiol. 1970; 28 (5): 596–608.CrossRefGoogle Scholar
Gattinoni, L, Protti, A, Caironi, P, Carlesso, E: Ventilator-induced lung injury: the anatomical and physiological framework. Crit.Care.Med. 2010; 38 (10 Suppl): S539–48.Google Scholar
Hess, DR: Respiratory mechanics in mechanically ventilated patients. Respir.Care. 2014; 59 (11): 1773–94.CrossRefGoogle ScholarPubMed
Gattinoni, L, Marini, JJ, Pesenti, A, Quintel, M, Mancebo, J, Brochard, L: The “baby lung” became an adult. Intens. Care. Med. 2016; 42 (5): 663–73.CrossRefGoogle Scholar
Slutsky, AS: Ventilator-induced lung injury: from barotrauma to biotrauma. Respir.Care. 2005; 50 (5): 646–59.Google Scholar
Gallart, L, Canet, J: Post-operative pulmonary complications: understanding definitions and risk assessment. Best.Pract.Res.Clin.Anaesthesiol. 2015; 29 (3): 315–30.CrossRefGoogle ScholarPubMed
Canet, J, Gallart, L, Gomar, C, Paluzie, G, Valles, J, Castillo, J, et al: Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology. 2010; 113 (6): 1338–50.CrossRefGoogle Scholar
Allan, N, Siller, C, Breen, A: Anaesthetic implications of chemotherapy. BJA.Educ. 2011; 12 (2): 52–6.Google Scholar
Habre, W, Petak, F: Perioperative use of oxygen: variabilities across age. Br.J.Anaesth. 2014; 113 Suppl 2: ii26–36.Google Scholar
Edmark, L, Kostova-Aherdan, K, Enlund, M, Hedenstierna, G: Optimal oxygen concentration during induction of general anesthesia. Anesthesiology. 2003; 98 (1): 28–33.Google Scholar
Shankar, P, Robson, SC, Otterbein, LE, Shaefi, S: Clinical implications of hyperoxia. Int.Anesthesiol.Clin. 2018; 56 (1): 68–79.Google Scholar
Hovaguimian, F, Lysakowski, C, Elia, N, Tramer, MR: 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. Anesthesiology. 2013; 119 (2): 303–16.Google Scholar
Hedenstierna, G, Edmark, L: Protective ventilation during anesthesia: is it meaningful? Anesthesiology. 2016; 125 (6): 1079–82.Google Scholar
Hedenstierna, G: Oxygen and anesthesia: what lung do we deliver to the post-operative ward? Acta.Anaesthesiol.Scand. 2012; 56 (6): 675–85.CrossRefGoogle Scholar
Lachmann, B: Open lung in ARDS. Minerva.Anestesiol. 2002; 68 (9): 637–42.Google Scholar
Lachmann, B: Open up the lung and keep the lung open. Intens.Care.Med. 1992; 18 (6): 319–21.Google Scholar
Ball, L, Dameri, M, Pelosi, P: Modes of mechanical ventilation for the operating room. Best.Pract.Res.Clin.Anaesthesiol. 2015; 29 (3): 285–99.Google Scholar
Serpa Neto, A, Hemmes, SN, Barbas, CS, Beiderlinden, M, Biehl, M, Binnekade, JM, et al: Protective versus conventional ventilation for surgery: a systematic review and individual patient data meta-analysis. Anesthesiology. 2015; 123 (1): 66–78.CrossRefGoogle ScholarPubMed
Hemmes, SN, Gama de Abreu, M, Pelosi, P, Schultz, MJ: High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial. Lancet. 2014; 384 (9942): 495–503.Google Scholar
Suter, PM, Fairley, B, Isenberg, MD: Optimum end-expiratory airway pressure in patients with acute pulmonary failure. N.Engl.J.Med. 1975; 292 (6): 284–9.Google Scholar
Rouby, JJ, Puybasset, L, Cluzel, P, Richecoeur, J, Lu, Q, Grenier, P: Regional distribution of gas and tissue in acute respiratory distress syndrome. II. Physiological correlations and definition of an ARDS Severity Score. CT Scan ARDS Study Group. Intens.Care.Med. 2000; 26 (8): 1046–56.Google Scholar
Lu, Q, Rouby, JJ: Measurement of pressure-volume curves in patients on mechanical ventilation: methods and significance. Crit.Care. 2000; 4 (2): 91–100.CrossRefGoogle ScholarPubMed
Schultz, MJ, Abreu, MG, Pelosi, P: Mechanical ventilation strategies for the surgical patient. Curr.Opin.Crit.Care. 2015; 21 (4): 351–7.Google Scholar
Rossner, S. Paul Pierre Broca (1824–1880). Obes.Rev. 2007; 8 (3): 277.CrossRefGoogle Scholar
Amato, MB, Meade, MO, Slutsky, AS, Brochard, L, Costa, EL, Schoenfeld, DA, et al: Driving pressure and survival in acute respiratory distress syndrome. N.Engl.J.Med. 2015; 372 (8): 747–55.Google Scholar
Loring, SH, Malhotra, A: Driving pressure and respiratory mechanics in ARDS. N.Engl.J.Med. 2015; 372 (8): 776–7.Google Scholar
Bugedo, G, Retamal, J, Bruhn, A: Driving pressure: a marker of severity, a safety limit, or a goal for mechanical ventilation? Crit.Care. 2017; 21 (1): 199.Google Scholar
Richard, JC, Maggiore, SM, Mercat, A: Clinical review: bedside assessment of alveolar recruitment. Crit.Care. 2004; 8 (3): 163–9.Google Scholar
Brochard, L. Intrinsic (or auto-) PEEP during controlled mechanical ventilation. Intens.Care.Med. 2002; 28 (10): 1376–8.Google Scholar
Rossi, A, Polese, G, Brandi, G, Conti, G: Intrinsic positive end-expiratory pressure (PEEPi). Intens.Care.Med. 1995; 21 (6): 522–36.Google Scholar
Tobin, MJ, Lodato, RF: PEEP, auto-PEEP, and waterfalls. Chest. 1989; 96 (3): 449–51.Google Scholar
Blanch, PB, Jones, M, Layon, AJ, Camner, N: Pressure-present ventilation. Part 1: Physiologic and mechanical considerations. Chest. 1993; 104 (2): 590–9.Google Scholar
Gilstrap, D, MacIntyre, N: Patient-ventilator interactions. Implications for clinical management. Am.J.Respir.Crit.Care.Med. 2013; 188 (9): 1058–68.Google Scholar
Guldner, A, Pelosi, P, de Abreu, MG: Nonventilatory strategies to prevent postoperative pulmonary complications. Curr.Opin.Anaesthesiol. 2013; 26 (2): 141–51.Google Scholar
Canet, J, Gallart, L: Postoperative respiratory failure: pathogenesis, prediction, and prevention. Curr.Opin.Crit.Care. 2014; 20 (1): 56–62.Google Scholar
Sasaki, N, Meyer, MJ, Eikermann, M: Postoperative respiratory muscle dysfunction: pathophysiology and preventive strategies. Anesthesiology. 2013; 118 (4): 961–78.CrossRefGoogle ScholarPubMed
Warner, DO: Preventing postoperative pulmonary complications: the role of the anesthesiologist. Anesthesiology. 2000; 92 (5): 1467–72.Google Scholar
Ogilvie, L: Difficult Airway Society guidelines for the management of tracheal extubation. Anaesthesia. 2012; 67 (11): 1277–8.Google Scholar
Schadler, D, Miestinger, G, Becher, T, Frerichs, I, Weiler, N, Hormann, C: Automated control of mechanical ventilation during general anaesthesia: study protocol of a bicentric observational study (AVAS). BMJ.Open. 2017; 7 (5): e014742.Google Scholar

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