Do we have the 'power' to 'drive' down the incidence of pulmonary

Br J Anaesth · Jan 2023

Editorial Comment

Do we have the 'power' to 'drive' down the incidence of pulmonary complications after thoracic surgery.

The concept, mechanisms, and physical and physiological determinants of ventilator-induced lung injury, as well as the influence of lung-protective ventilation strategies, are novel paradigms of modern intensive care and perioperative medicine. Driving pressure and mechanical power have emerged as meaningful and modifiable targets with specific relevance to thoracic anaesthesia and one-lung ventilation. The relationship between these factors and postoperative pulmonary complications remains complex because of the methodological design and outcome selection. Larger observational studies are required to better understand the characteristics of driving pressure and power in current practice of thoracic anaesthesia in order to design future trials in high-risk thoracic populations at risk of acute lung injury.

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- Ben Shelley and Nandor Marczin.
- Department of Cardiothoracic Anaesthesia and Intensive Care, Golden Jubilee National Hospital, Glasgow, UK; Anaesthesia, Perioperative Medicine and Critical Care Research Group, University of Glasgow, Glasgow, UK. Electronic address: Benjamin.Shelley@glasgow.ac.uk.
- Br J Anaesth. 2023 Jan 1; 130 (1): e37e40e37-e40.
AbstractThe concept, mechanisms, and physical and physiological determinants of ventilator-induced lung injury, as well as the influence of lung-protective ventilation strategies, are novel paradigms of modern intensive care and perioperative medicine. Driving pressure and mechanical power have emerged as meaningful and modifiable targets with specific relevance to thoracic anaesthesia and one-lung ventilation. The relationship between these factors and postoperative pulmonary complications remains complex because of the methodological design and outcome selection. Larger observational studies are required to better understand the characteristics of driving pressure and power in current practice of thoracic anaesthesia in order to design future trials in high-risk thoracic populations at risk of acute lung injury.Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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Do we have the 'power' to 'drive' down the incidence of pulmonary complications after thoracic surgery.

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