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Postoperative respiratory muscle dysfunction: pathophysiology and preventive strategies
Nobuo Sasaki1, Matthew J Meyer, Matthias Eikermann
1Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Anesthesiology
|February 23, 2013
Summary
Postoperative pulmonary complications are often caused by respiratory muscle dysfunction. Strategies like minimally invasive surgery and early mobilization can help prevent this dysfunction and improve patient outcomes.
Area of Science:
- Anesthesiology
- Pulmonology
- Critical Care Medicine
Background:
- Postoperative pulmonary complications significantly increase healthcare costs and patient morbidity/mortality.
- Respiratory muscle dysfunction, particularly involving upper airway dilators, is a key contributing factor.
- Perioperative factors like medications, interventions, and patient conditions differentially affect respiratory muscle function.
Purpose of the Study:
- To elucidate the impact of perioperative factors on respiratory muscle subgroups.
- To identify strategies for mitigating postoperative respiratory muscle dysfunction.
Main Methods:
- Review of existing literature on perioperative influences on respiratory muscles.
- Analysis of the effects of anesthetics, sedatives, opioids, mechanical ventilation, and patient comorbidities on respiratory muscle function.
Main Results:
- Various perioperative elements impair the coordination and function of upper airway dilators and respiratory pump muscles.
- This impairment can lead to respiratory failure.
- Specific patient conditions like obesity and obstructive sleep apnea exacerbate these effects.
Conclusions:
- Perioperative management strategies are crucial for reducing postoperative respiratory muscle dysfunction.
- Recommendations include favoring minimally invasive procedures, early mobilization, judicious medication use, and noninvasive ventilation.
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