Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine, Vita Salute San Raffaele University, Milan, Italy.
Department of Anesthesiology and Intensive Care, First Moscow State Medical University, Moscow, Russia; V. Negovsky Reanimatology Research Institute, Moscow, Russia.
J Cardiothorac Vasc Anesth. 2022 Mar;36(3):785-793. doi: 10.1053/j.jvca.2021.03.023. Epub 2021 Mar 20.
Postoperative pulmonary complications and acute respiratory failure are among the leading causes of adverse postoperative outcomes. Noninvasive ventilation may safely and effectively prevent acute respiratory failure in high-risk patients after cardiothoracic surgery and after abdominal surgery. Moreover, noninvasive ventilation can be used to treat postoperative hypoxemia, particularly after abdominal surgery. Noninvasive ventilation also can be helpful to prevent or manage intraoperative acute respiratory failure during non-general anesthesia, primarily in patients with poor respiratory function. Finally, noninvasive ventilation is superior to standard preoxygenation in delaying desaturation during intubation in morbidly obese and in critically ill hypoxemic patients. The few available studies in children suggest that noninvasive ventilation could be safe and valuable in treating hypoxemic or hypercapnic acute respiratory failure after cardiac surgery; on the other hand, it could be dangerous after tracheoesophageal correction.
术后肺部并发症和急性呼吸衰竭是术后不良结局的主要原因之一。无创通气可安全有效地预防心胸手术后和腹部手术后高危患者的急性呼吸衰竭。此外，无创通气可用于治疗术后低氧血症，尤其是腹部手术后。无创通气也有助于预防或处理非全身麻醉期间的术中急性呼吸衰竭，主要针对呼吸功能不佳的患者。最后，在病态肥胖和严重低氧血症患者中，无创通气在插管期间延迟脱氧方面优于标准预充氧。为数不多的儿科可用研究表明，无创通气在治疗心脏手术后低氧血症或高碳酸血症性急性呼吸衰竭时可能是安全且有价值的；另一方面，在气管食管矫正术后可能是危险的。
