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Lung protection during general anaesthesia

Over the past two decades it has become a well-established fact that general anaesthesia, although considered safe, may impair the respiratory system. Muscle paralysis, airway management, mechanical ventilation, patient position and surgery are contributing factors – individually or in combination – and may lead to complications. We will shed some light on various aspects of lung protective ventilation in the OR. That's why we are Your Specialist in Acute Care.

Which ventilator settings and parameters could contribute to a protective ventilation strategy?

More than 230 million surgical procedures are undertaken each year worldwide1. Many of these patients receive general anaesthesia with its attendant mechanical ventilation, which exposes them to the potential risk of postoperative pulmonary complications. Although results from research conducted on this topic are inconclusive, evidence gained over the past few years suggests the use of lung protection strategies for surgical patients despite the fact that not all questions have been sufficiently answered.

This article explores the current discussion on intraoperative lung protective ventilation strategies. The literature reviewed focuses the discussion on the following ventilator settings and parameters: tidal volume (VT), use of positive end-expiratory pressure (PEEP) and applied oxygen fraction (FiO2) as well as recruitment manoeuvres and plateau/driving pressures. Many studies discuss the effects of tidal volume ranges on the lungs during intraoperative ventilation. These trials have suggested that lung protective strategies encompassing reduced VT have a positive effect on the incidence of PPCs2. This is, however, not a standard of care in the operating theatre at present. On the other hand, the use and benefit of PEEP still appear to be controversial. At the moment an optimal PEEP remains to be defined; the discussion currently tends toward moderate to low PEEP3. In addition, titrated approaches are being suggested in order to adapt PEEP and recruitment manoeuvres to the individual patient. Regarding FiO2, it was assumed in the past that a high inspired oxygen fraction would improve oxygenation and reduce postoperative nausea and vomiting (PONV) as well as prevent surgical site infections: Today, this perception seems to have changed1.

Click on the button below to download the clinical whitepaper and also the Technology Insights to receive more information on how you can reduce postoperative pulmonary complications (PPCs) and how Dräger technologies can support you.

Stay tuned to protective ventilation in the OR

There is an increasing call for protective ventilation during anaesthesia. We stay tuned to the latest developments and current literature on this topic. In addition, our whitepaper provides even more background information in accordance with the scientific literature.

Whitepaper: Options to reduce PPCs

On the basis of condensed background information, intraoperative lung protection strategies are explored. This article provides an overview of current literature-based recommendations to reduce PPCs.

Get the whitepaper

Technology Insights: protective ventilation

This paper outlines how our technology supports the application of protective ventilation strategies in the OR.

Download the paper


Whitepaper: Deploying protective ventilation

In the whitepaper we will provide an overview of a potential different challenge faced when implementing e. g. protective ventilation.

Get the whitepaper

More support for protective ventilation in the OR

Protective ventilation in the OR creates significant demands on the anaesthesia workstation. In the following, further materials / contents will be made available, which can help to assess the topic or provide added value.

Advanced Ventilation Techniques

Advanced Ventilation Techniques session at ANZCA hosted by Dr Chris Thompson, Specialist Anaesthetist from Royal Prince Alfred Hospital.

There is increasing evidence that lung protective ventilation in the OR may have substantial benefits regarding the postoperative outcome.

Dräger Lunch Symposium at Euroanaesthesia 2016, London, UK: ”Rethink Ventilation in the Operation Room“

“Protective Mechanical Ventilation in the Operating Room”
Lecture by Prof. Dr. Paolo Pelosi (Genoa, Italy)

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Lung recruitment during general anaesthesia

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Illustration of a lung protected in an orb

The Big Impact of Lung Protective Ventilation

Get a deeper understanding of how to fit every patient’s lung ventilation needs and learn how you can improve patient outcomes whilst maximising hospital’s resources.

Get in touch

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Дрегер Медикал България ЕООД

бул.Джеймс Баучер 2
гр.София, п.к. 1164

+359 2963 4403

Dräger Slovenija d.o.o.

Nadgoriška cesta 19
12 31 Ljubljana-Črnuče

+386 1 561 2263


  1. Weiser, TG, Regenbogen, SE, Thompson, KD et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 2008; 372: 139–144
  2. Serpa Neto, A, Schultz, MJ, Slutsky, AS. Current concepts of protective ventilation during general anaesthesia. Swiss Med Wkly. 2015;145 :w14211
  3. Pelosi P, Ball L. Intraoperative mechanical ventilation in patients with non-injured lungs: time to talk about tailored protective ventilation? Ann Transl Med 2016 Jan;4(1):17