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Pulmonary atelectasis after anaesthesia: pathophysiology and management
Canadian Anaesthetists' Society Journal
|July 1, 1981
Summary
Pulmonary atelectasis, or lung collapse, is caused by alveolar instability. Identifying and managing risk factors like low lung volume and smoking is key to preventing this condition.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Pulmonary atelectasis arises from alveolar instability due to surface tension and regional alveolar size variations.
- Several factors exacerbate the lung's tendency to collapse, impacting respiratory function.
Purpose of the Study:
- To review the pathophysiological basis of pulmonary atelectasis.
- To discuss risk factors contributing to lung collapse.
- To outline management strategies for prevention and treatment.
Main Methods:
- Literature review of pathophysiological mechanisms of atelectasis.
- Identification and categorization of risk factors.
- Analysis of current management strategies and their rationales.
Main Results:
- Key risk factors include low lung volume, high closing volume, oxygen therapy, shallow breathing, chronic lung disease, smoking, obesity, postoperative pain, and neuromuscular diseases.
- Perioperative respiratory management aims to prevent atelectasis through physiotherapy and optimizing respiratory status.
Conclusions:
- Preventing pulmonary atelectasis involves addressing modifiable risk factors and implementing appropriate perioperative respiratory care.
- Strategies include physiotherapy, delaying surgery for respiratory improvement, and in specific cases, controlled postoperative ventilation.