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Perioperative Pulmonary Atelectasis: Part I. Biology and Mechanisms.

Authors :
Zeng C
Lagier D
Lee JW
Vidal Melo MF
Source :
Anesthesiology [Anesthesiology] 2022 Jan 01; Vol. 136 (1), pp. 181-205.
Publication Year :
2022

Abstract

Pulmonary atelectasis is common in the perioperative period. Physiologically, it is produced when collapsing forces derived from positive pleural pressure and surface tension overcome expanding forces from alveolar pressure and parenchymal tethering. Atelectasis impairs blood oxygenation and reduces lung compliance. It is increasingly recognized that it can also induce local tissue biologic responses, such as inflammation, local immune dysfunction, and damage of the alveolar-capillary barrier, with potential loss of lung fluid clearance, increased lung protein permeability, and susceptibility to infection, factors that can initiate or exaggerate lung injury. Mechanical ventilation of a heterogeneously aerated lung (e.g., in the presence of atelectatic lung tissue) involves biomechanical processes that may precipitate further lung damage: concentration of mechanical forces, propagation of gas-liquid interfaces, and remote overdistension. Knowledge of such pathophysiologic mechanisms of atelectasis and their consequences in the healthy and diseased lung should guide optimal clinical management.<br /> (Copyright © 2021, the American Society of Anesthesiologists. All Rights Reserved.)

Details

Language :
English
ISSN :
1528-1175
Volume :
136
Issue :
1
Database :
MEDLINE
Journal :
Anesthesiology
Publication Type :
Academic Journal
Accession number :
34499087
Full Text :
https://doi.org/10.1097/ALN.0000000000003943