Lytle Francis Theodore, Brown Daniel R
Department of Anesthesia, Division of Critical Care, Mayo Clinic, Rochester, Minnesota 55905, USA.
Semin Cardiothorac Vasc Anesth. 2008 Jun;12(2):97-108. doi: 10.1177/1089253208319869.
Mechanical ventilation of patients undergoing thoracic surgery is often challenging. These patients frequently have significant underlying comorbidities, including cardiopulmonary disease, and often must undergo 1-lung ventilation. Perioperative respiratory complications are common and are multifactorial in etiology. Increasing evidence suggests that mechanical ventilation is associated with, and may even cause, lung damage in both sick and healthy patients. Gas exchange to provide acceptable end-organ oxygenation remains a primary goal but so too is minimization of risks for acute lung injury. Every ventilator strategy is associated with potential beneficial and adverse side effects. Understanding the impact of various ventilation strategies allows clinicians to provide optimal care for patients.
胸外科手术患者的机械通气常常具有挑战性。这些患者通常存在严重的基础合并症，包括心肺疾病，且常常必须接受单肺通气。围手术期呼吸并发症很常见，其病因是多因素的。越来越多的证据表明，机械通气在患病和健康患者中均与肺损伤有关，甚至可能导致肺损伤。提供可接受的终末器官氧合的气体交换仍然是主要目标，但将急性肺损伤风险降至最低也是目标之一。每种通气策略都有潜在的有益和不良副作用。了解各种通气策略的影响有助于临床医生为患者提供最佳护理。
