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The Role of Protective Ventilation in Cardiac Surgery Patients

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Intensive Care Medicine

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Abstract

Cardiac surgery is associated with a pulmonary and systemic inflammatory response. The pulmonary effects of this inflammatory reaction are often modest: decreased lung compliance, pulmonary edema, increased intrapulmonary shunt fraction and decreased functional residual capacity (FRC) [1], Less than 2% of patients undergoing cardiac surgery develop full blown respiratory failure, the acute respiratory distress syndrome (ARDS) [1]. For example, after cardiac surgery, FRC is reduced up to 40–50% during the first 24 hours after extubation [2]. However, after general anesthesia, FRC is only decreased by 20–30% [3]. This exaggerated disturbance of pulmonary function is not yet fully understood. It has been suggested that this impaired pulmonary function is the result of pulmonary inflammation, triggered by cardiopulmonary bypass (CPB), ischemia-reperfusion injury, the surgical procedure itself, or by mechanical ventilation.

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Author information

Authors and Affiliations

  1. Department of Intensive Care, room H-602, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, Netherlands

    D. Gommers & D. dos Reis Miranda

Authors
  1. D. Gommers
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  2. D. dos Reis Miranda
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Editor information

Editors and Affiliations

  1. Department of Intensive Care Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070, Brussels, Belgium

    Jean-Louis Vincent MD, PhD, FCCM, FCCP (Head) (Head)

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Gommers, D., dos Reis Miranda, D. (2007). The Role of Protective Ventilation in Cardiac Surgery Patients. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-49518-7_36

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  • DOI: https://doi.org/10.1007/978-0-387-49518-7_36

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-49517-0

  • Online ISBN: 978-0-387-49518-7

  • eBook Packages: MedicineMedicine (R0)

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