Current concepts of protective ventilation during general anaesthesia

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Pulmonary Medicine

Background:

• Traditionally, high tidal volumes (VT) were used in mechanical ventilation during surgery to improve oxygenation and lung function.
• Positive end-expiratory pressure (PEEP) was often avoided due to concerns about cardiovascular compromise.

Purpose of the Study:

• To evaluate the importance of lung-protective ventilation strategies during general anesthesia.
• To update understanding of ventilation-induced lung injury (VILI) in the context of intraoperative care.

Main Methods:

• Review of recent randomized controlled trials (RCTs) in patients undergoing general anesthesia.
• Analysis of data concerning ventilation strategies, including tidal volume, PEEP, and oxygen concentrations.

Main Results:

• Lung-protective strategies, including low VT and PEEP, are important during intraoperative ventilation.
• These strategies help mitigate ventilation-induced lung injury.
• Optimizing oxygen concentrations is also a key component of lung protection.

Conclusions:

• Lung-protective ventilation, incorporating low VT and PEEP, should be considered standard practice during general anesthesia.
• This approach improves patient safety by reducing the risk of VILI.
• Further research supports the benefits of lung-protective ventilation beyond the intensive care unit.