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Current Anesthesiology Reports

Erschienen in:

01.06.2014 | Thoracic Anesthesia (T Schilling, Section Editor)

Protective Ventilatory Approaches to One-Lung Ventilation: More than Reduction of Tidal Volume

verfasst von: Alf Kozian, Thomas Schilling

Erschienen in: Current Anesthesiology Reports | Ausgabe 2/2014

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Abstract

The thoracic surgical patient is at special risk for increased postoperative pulmonary complications, such as atelectasis, impaired lung function and pneumonia, as well as acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) with high mortality after lung resections. One-lung ventilation (OLV) induces proinflammatory responses especially in the ventilated lung, based on mechanical stress, persistent hyperperfusion, increased gas content and ventilation to perfusion mismatching. ALI may occur, even in previously healthy lungs. Ventilation management can cause and exacerbate but also attenuate ALI after OLV. Protective ventilatory approaches can improve the outcome by minimizing lung damage. However, ventilation with lower tidal volumes during OLV does not completely abolish alveolar inflammation. The present review addresses the effects of OLV and their role in ventilator-induced lung injury. Lung protective strategies to one-lung ventilation that additionally include reduction of cyclic alveolar recruitment, PEEP ventilation, limitation of inspired oxygen and pharmacological preconditioning by volatile anesthetics are discussed.

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Titel: Protective Ventilatory Approaches to One-Lung Ventilation: More than Reduction of Tidal Volume
verfasst von: Alf Kozian
Thomas Schilling
Publikationsdatum: 01.06.2014
Verlag: Springer US
Erschienen in: Current Anesthesiology Reports / Ausgabe 2/2014
Elektronische ISSN: 2167-6275
DOI: https://doi.org/10.1007/s40140-014-0057-6

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Springer Medizin

Protective Ventilatory Approaches to One-Lung Ventilation: More than Reduction of Tidal Volume

Abstract

Neu im Fachgebiet AINS

Hinter dieser Appendizitis steckte ein Erreger

Ärztliche Empathie hilft gegen Rückenschmerzen

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

S3-Leitlinie zu Pankreaskrebs aktualisiert

Update AINS

Springer Medizin

Abstract

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Neu im Fachgebiet AINS

Hinter dieser Appendizitis steckte ein Erreger

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Update AINS