![]() Recently, randomized controlled trials (RCTs) on the topic have reported conflicting results. Two previous meta-analyses addressing similar research questions have been published, 13, 14 but the inclusion of observational studies compromised the reliability of the results. 11, 12 However, in anesthetized patients without the syndrome, the role of lung-protective ventilation remains unclear. 11 Lung-protective ventilation has been found to reduce morbidity and mortality among patients with acute lung injury and acute respiratory distress syndrome. Lung-protective ventilation refers to the use of low tidal volumes and moderate to high levels of positive end-expiratory pressure, with or without a recruitment manoeuvre. 7 – 9 Mechanical ventilation using high tidal volumes can result in overdistention of alveoli that mainly causes ventilator-associated lung injury. 6 However, unequivocal evidence from experimental and clinical studies suggests that mechanical ventilation, especially the use of high tidal volumes, may cause or aggravate lung injury. Conventional mechanical ventilation with tidal volumes of 10 to 15 mL/kg has been advocated to prevent hypoxemia and atelectasis in anesthetized patients undergoing surgery. Mechanical ventilation is mandatory in patients undergoing surgical procedures during general anesthesia. 2 – 5 Thus, prevention of these complications has become a high priority of perioperative care. 1 Postoperative pulmonary complications, including lung injury, pneumonia and atelectasis, are common and a major cause of morbidity and death. Implementation of a lung-protective ventilation strategy with lower tidal volumes may lower the incidence of these outcomes.Įstimates suggest that more than 230 million patients undergo major surgical procedures worldwide each year. Interpretation: Anesthetized patients who received ventilation with lower tidal volumes during surgery had a lower risk of lung injury and pulmonary infection than those given conventional ventilation with higher tidal volumes.
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