Perioperative ventilatory strategies in cardiac surgery
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EN
Article de revue
Este ítem está publicado en
Best Practice & Research Clinical Anaesthesiology. 2015-09, vol. 29, p. 381–395
Resumen en inglés
Recent data promote the utilization of prophylactic protective ventilation even in patients without acute respiratory distress syndrome (ARDS), and especially after cardiac surgery. The implementation of specific perioperative ...Leer más >
Recent data promote the utilization of prophylactic protective ventilation even in patients without acute respiratory distress syndrome (ARDS), and especially after cardiac surgery. The implementation of specific perioperative ventilatory strategies in patients undergoing cardiac surgery can improve both respiratory and extra-pulmonary outcomes. Protective ventilation is not limited to tidal volume reduction. The major components of ventilatory management include assist-controlled mechanical ventilation with low tidal volumes (6-8 mL kg(-1) of predicted body weight) associated with higher positive end-expiratory pressure (PEEP), limitation of fraction of inspired oxygen (FiO2), ventilation maintenance during cardiopulmonary bypass, and finally recruitment maneuvers. In order for such strategies to be fully effective, they should be integrated into a multimodal approach beginning from the induction and continuing over the postoperative period.< Leer menos
Palabras clave
Article CLINIQUE
Palabras clave en inglés
Cardiac Surgery
Cardiopulmonary Bypass
Mechanical Ventilation
Oxygen
Peep
Recruitment
Tidal Volume/Physiology
Centros de investigación