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Lung Protection During General Anaesthesia - Draeger Lung Protection Low-Flow Anesthesia

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.

The article below 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.

Explore the clinical whitepaper and technology insights below for more information on how you can reduce postoperative pulmonary complications (PPCs).

Stay tuned to protective ventilation in the OR

There is an increasing call for protective ventilation during anaesthesia. Below we offer the latest developments and current literature on this topic including our whitepaper, which provides even more background information in accordance with the scientific literature.

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Whitepaper: Options to Reduce PPCs

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Technology Insights: Protective Ventilation

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Whitepaper: Deploying protective ventilation

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

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More support for protective ventilation in the OR

Protective ventilation in the OR creates significant demands on the anaesthesia workstation. Explore the videos below for even more information! 

Dräger at ANZCA 2015 - Dr Chris Thompson on Advanced Ventilation Techniques

Advanced Ventilation Techniques

Practical workshop: Advanced Ventilation techniques session at ANZCA
Lecture by Dr. Chris Thompson (Sydney, Australia)

Protective Mechanical Ventilation in the Operating Room

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)

Related topics in lung protection

Anaesthetists aim to prevent medical error in operating room

Errors in anaesthesia – whose fault is it anyway?

Lung Protection During Bariatric Surgery – adapted anaesthesia methods

Lung protection in obese patients during general anaesthesia

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Ventilation of the anaesthetised paediatric patient

Lung recruitment doctor reviewing xray

Lung recruitment during general anaesthesia

Draeger Intraoperative Spontaneous Breathing Lung protective ventilation

Intraoperative spontaneous breathing

Draeger low flow anesthesia

Low-flow anaesthesia for lung protection

Illustration of a lung protected in an orb

Protecting the Lung When It Matters Most

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

Learn more

Get in touch with Dräger

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Dräger South Africa (Pty) Ltd.

Johannesburg: 2 Ruacana Street, Waterfall Commercial District, (cnr Beatty Street), Buccleuch, 2090 

+27(0)11 059 4200

Postal Address: P.O. Box 4676 Rivonia, 2128 Republic of South Africa

Dräger South Africa (Pty) Ltd.

Cape Town:  Unit 7 on London, 7 London Circle Brackengate Business Park Brackenfall, 7561

+27(0)21 552 6713

Postal Address: P.O. Box 3677, Tygervalley 7536

Dräger South Africa (Pty) Ltd.

Durban: 17 Thynk Industrial Park Cnr Brickworks and Queen Nandi Drive, Briardene, Durban North, 7561

+27(0)31 812 7900

Postal Address: P.O. Box 40554, Redhill 4071

References

  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