Preventing Ventilator-Associated Lung Injury: A Perioperative Perspective

Area of Science:

• Critical Care Medicine
• Anesthesiology
• Respiratory Physiology

Background:

• Lung protective ventilation (LPV) strategies are established for preventing ventilator-associated lung injury (VALI) in acute respiratory distress syndrome (ARDS) patients.
• LPV is increasingly applied in operating rooms for healthy individuals undergoing mechanical ventilation.
• This review examines LPV history in acute respiratory failure and its application during general anesthesia.

Purpose of the Study:

• To review the history and application of lung protective strategies in patients with acute respiratory failure.
• To explore the use of lung protective ventilation in patients undergoing mechanical ventilation during general anesthesia.
• To discuss the benefits and drawbacks of LPV and identify future research directions.

Main Methods:

• A comprehensive database search was conducted.
• Articles investigating lung protective ventilation in both intensive care units (ICUs) and general anesthesia settings were reviewed.
• Literature review extended up to May 2015.

Main Results:

• Lung protective ventilation demonstrated improved outcomes in ICU patients with acute respiratory failure.
• Clinical evidence for the benefits of LPV in surgical patients remains less conclusive.
• LPV strategies are well-established for minimizing lung injury in critically ill patients.

Conclusions:

• Lung protective ventilation, including low tidal volume and moderate PEEP, is a standard therapy for critically ill patients.
• LPV may offer benefits to patients undergoing general anesthesia.
• Further research is warranted to clarify the role of LPV in surgical settings.