Perioperative ventilatory strategies in cardiac surgery
Language
EN
Article de revue
This item was published in
Best Practice & Research Clinical Anaesthesiology. 2015-09, vol. 29, p. 381–395
English Abstract
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 ...Read more >
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.Read less <
Keywords
Article CLINIQUE
English Keywords
Cardiac Surgery
Cardiopulmonary Bypass
Mechanical Ventilation
Oxygen
Peep
Recruitment
Tidal Volume/Physiology