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Revista Brasileira de Anestesiologia
Print version ISSN 0034-7094
On-line version ISSN 1806-907X
MALBOUISSON, Luiz Marcelo Sá et al. Atelectasis during anesthesia: pathophysiology and treatment. Rev. Bras. Anestesiol. [online]. 2008, vol.58, n.1, pp.73-83. ISSN 0034-7094. http://dx.doi.org/10.1590/S0034-70942008000100011.
BACKGROUND AND METHODS: The incidence of intraoperative pulmonary collapse is elevated in patients undergoing surgery under general anesthesia with muscle relaxation/paralysis. This complication is associated with worsening intraoperative gas exchange and, in some cases, the need for prolonged postoperative respiratory support. The objective of this report was to review the pathophysiological aspects of atelectasis during general anesthesia and possible therapeutic maneuvers that could prevent and treat this complication. CONTENTS: This review discusses the concepts about the incidence of intraoperative atelectasis, factors that influence their development, both mechanical and those related to mechanical ventilator settings during the surgery, diagnostic criteria, and strategies to prevent and treat this complication. CONCLUSIONS: Understanding of the mechanisms related with the development of intraoperative pulmonary collapse, as well as its treatment, can contribute to reduce the incidence of postoperative pulmonary complications, the length of recovery and hospital costs.
Keywords : COMPLICATIONS [atelectasis]; COMPLICATIONS [pulmonary collapse]; VENTILATION [mechanical controlled]; VENTILATION [alveolar recruitment maneuver]; VENTILATION [positive end-expiratory pressure].