LELLOUCHE, F.; DELORME, M.; BUSSIÈRE, J.; OUATTARA, A.

doi:10.1016/j.bpa.2015.08.006

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LELLOUCHE, F.

DELORME, M.
Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases

BUSSIÈRE, J.

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Article de revue

Ce document a été publié dans

Best Practice & Research Clinical Anaesthesiology. 2015-09, vol. 29, p. 381–395

Résumé en anglais

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.< Réduire

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Article CLINIQUE

Mots clés en anglais

Cardiac Surgery

Cardiopulmonary Bypass

Mechanical Ventilation

Oxygen

Peep

Recruitment

Tidal Volume/Physiology