• Best Pract Res Clin Anaesthesiol · Sep 2015

    Review

    Perioperative ventilatory strategies in cardiac surgery.

    • François Lellouche, Mathieu Delorme, Jean Bussières, and Alexandre Ouattara.
    • Institut Universitaire de Cardiologie et Pneumologie de Québec, Faculté de Médecine, Université Laval, Ville de Québec, Canada. Electronic address: francois.lellouche@criucpq.ulaval.ca.
    • Best Pract Res Clin Anaesthesiol. 2015 Sep 1; 29 (3): 381395381-95.

    AbstractRecent data promote the utilization of prophylactic protective ventilation even in patients without acute respiratory distress syndrome (ARDS), and especially after cardiac surgery. The implementation of specific perioperative ventilatory strategies in patients undergoing cardiac surgery can improve both respiratory and extra-pulmonary outcomes. Protective ventilation is not limited to tidal volume reduction. The major components of ventilatory management include assist-controlled mechanical ventilation with low tidal volumes (6-8 mL kg(-1) of predicted body weight) associated with higher positive end-expiratory pressure (PEEP), limitation of fraction of inspired oxygen (FiO2), ventilation maintenance during cardiopulmonary bypass, and finally recruitment maneuvers. In order for such strategies to be fully effective, they should be integrated into a multimodal approach beginning from the induction and continuing over the postoperative period.Copyright © 2015 Elsevier Ltd. All rights reserved.

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