The lung during and after thoracic anaesthesia

Increased awareness of widespread atelectasis and deoxygenation after cardiac surgery, and in the ventilated lung during one-lung anaesthesia, has prompted many studies on recruitment of collapsed tissue and other methods to treat hypoxia in the perioperative period. It is therefore time to summarize what benefits might come from such manoeuvres.

Major findings are that recruitment by different, often vigorous inflation of the lungs improves oxygenation and that this can also be seen when a recruitment manoeuvre is done of the ventilated lung in one-lung anaesthesia. The inspired oxygen fraction seems to be an important determinant of how long the recruitment persists.

Recruitment manoeuvres are highly efficient in improving oxygenation but often for a limited period. So they have to be repeated. To what extent they may affect hospital stay and other variables of outcome, remains to be shown.