Acta Scientific Medical Sciences (ISSN: 2582-0931)

Mini Review Volume 4 Issue 2

Mechanical Ventilation in the Operating Room: Evidence and Current Practice

Suvadeep Sen*

Consultant Intensivist, Apollo Hospital, CBD Belapur, Navi Mumbai, Maharashtra, India

*Corresponding Author: Suva Deep Sen, Consultant Intensivist, Apollo Hospital, CBD Belapur, Navi Mumbai, Maharashtra, India.

Received: December 17, 2019; Published: January 24, 2020

Orcid ID:

Researcher ID: AAG-3753-2019



  General anaesthesia is an integral part of a standard operating practice. Ventilation strategy during general anaesthesia, despite being a key parameter determining peri-operative success, is the often neglected and comes as a least important anaesthetic consideration in contemporary practice.

Keywords: Ventilation; Operating Room; Surgery; Anaesthesia



  1. Gattinoni L., et al. “Ventilator-related causes of lung injury: the mechanical power”. Intensive Care Medicine 42.10 (2016): 1567-1575. 
  2. Bendixen HH., et al. “Impaired Oxygenation in Surgical Patients During General Anesthesia With Controlled Ventilation. a Concept of Atelectasis”. The New England Journal of Medicine 269 (1963): 991-996. 
  3. Brower RG., et al. “Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome”. The New England Journal of Medicine 342.18 (2000): 1301-1308. 
  4. Serpa Neto A., et al. “Association Between Use of Lung-Protective Ventilation with Lower Tidal Volumes and Clinical Outcomes Among Patients Without Acute Respiratory Distress Syndrome: A Meta-analysis”. Journal of the American Medical Association 308.16 (2012): 1651-1659. 
  5. Neto AS., et al. “Lung-protective ventilation with low tidal volumes and the occurrence of pulmonary complications in patients without acute respiratory distress syndrome: A systematic review and individual patient data analysis”. Critical Care Medicine 43.10 (2015): 2155-2163. 
  6. Investigators WG for the Pr. “Effect of a Low vs Intermediate Tidal Volume Strategy on Ventilator-Free Days in Intensive Care Unit Patients Without ARDS: A Randomized Clinical Trial”. Journal of the American Medical Association 320.18 (2018): 1872-1880. 
  7. Duggan M and Kavanagh BP. “Pulmonary atelectasis: A pathogenic perioperative entity”. Anesthesiology 102.4 (2005): 1-19. 
  8. Fernandez-Bustamante A., et al. “Postoperative Pulmonary Complications, Early Mortality, and Hospital Stay Following Noncardiothoracic Surgery: A Multicenter Study by the Perioperative Research Network Investigators”. JAMA Surgery 152.2 (2017): 157-166. 
  9. Futier E., et al. “A trial of intraoperative low-tidal-volume ventilation in abdominal surgery”. The New England Journal of Medicine 369.5 (2013): 428-437. 
  10. Severgnini P., et al. “Protective mechanical ventilation during general anesthesia for open abdominal surgery improves postoperative pulmonary function”. Anesthesiology 118.6 (2013): 1307-1321. 
  11. Chaney MA., et al. “Protective ventilation attenuates postoperative pulmonary dysfunction in patients undergoing cardiopulmonary bypass”. Journal of Cardiothoracic and Vascular Anesthesia 14.5 (2000): 514-518. 
  12. Miranda DR., et al. “Open lung ventilation improves functional residual capacity after extubation in cardiac surgery”. Critical Care Medicine 33.10 (2005): 2253-2258. 
  13. Yang M., et al. “Does a protective ventilation strategy reduce the risk of pulmonary complications after lung cancer surgery?: A randomized controlled trial”. Chest 139.3 (2011): 530-537. 
  14. Michelet P. “Protective Ventilation Influences Systemic Inflammation after Esophagectomy”. 5 (2006): 911-919. 
  15. Shen Y., et al. “The impact of tidal volume on pulmonary complications following minimally invasive esophagectomy: A randomized and controlled study”. The Journal of Thoracic and Cardiovascular Surgery 146.5 (2013): 1267-1274. 
  16. Ge Y., et al. “Effect of lung protection mechanical ventilation on respiratory function in the elderly undergoing spinal fusion”. Journal of Central South University (Medical Sciences) 38.1 (2013): 81-85. 
  17. Zupancich E., et al. “Mechanical ventilation affects inflammatory mediators in patients undergoing cardiopulmonary bypass for cardiac surgery: A randomized clinical trial”. The Journal of Thoracic and Cardiovascular Surgery 130.2 (2005): 378-383. 
  18. Lin WQ., et al. “Effects of the lung protective ventilatory strategy on proinflammatory cytokine release during one-lung ventilation”. Ai Zheng 27.8 (2008): 870-873. 
  19. Wolthuis EK., et al. “Mechanical Ventilation with Lower Tidal Volumes and Positive End-expiratory Pressure Prevents Alveolar Coagulation in Patients without Lung Injury”. Anesthesiology 105.1 (2006): 689-695. 
  20. Hemmes SNT., et al. “Intraoperative ventilatory strategies to prevent postoperative pulmonary complications: A meta-analysis”. Current Opinion in Anesthesiology 26.2 (2013):126-133. 
  21. Yang D., et al. “A meta-analysis of intraoperative ventilation strategies to prevent pulmonary complications. Is low tidal volume alone sufficient to protect healthy lungs?” Annals of Surgery 263.5 (2016): 881-887. 
  22. Patel JM., et al. “Intra-operative adherence to lung-protective ventilation: a prospective observational study”. Perioperative Medicine 5.1 (2016): 1-8. 
  23. Jaber S., et al. “A multicentre observational study of intra-operative ventilatory management during general anaesthesia: Tidal volumes and relation to body weight”. Anaesthesia 67.9 (2012): 999-1008. 
  24. Hess DR., et al. “A 5-year observational study of lung-protective ventilation in the operating room: A single-center experience”. Journal of Critical Care 28.4 (2013): 533.e9-533.e15. 
  25. Colinet B., et al. “Mechanical ventilation practices in the operating room. Survey of the anesthesiology society of Charleroi “vENTISAC”. Acta Anaesthesiologica Belgica 68.2 (2017): 81-86. 
  26. Wolthuis EK., et al. “Mechanical ventilation with lower tidal volumes and positive end-expiratory pressure prevents pulmonary inflammation in patients without preexisting lung injury”. Anesthesiology 108.1 (2008): 46-54. 
  27. Serpa Neto A., et al. “Dissipated Energy is a Key Mediator of VILI: Rationale for Using Low Driving Pressures” (2016): 311-321. 
  28. Lancet T and Medicine R. “Association between driving pressure and development of postoperative pulmonary complications in patients undergoing mechanical ventilation for general anaesthesia: A meta-analysis of individual patient data”. The Lancet Respiratory Medicine 4 (2016): 272-280.
  29. Blum JM., et al. “Preoperative and intraoperative predictors of postoperative acute respiratory distress syndrome in a general surgical population”. Anesthesiology 118.1 (2013): 19-29. 
  30. Ladha K., et al. “Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: Hospital based registry study”. British Medical Journal (2015): 351. 
  31. Wirth S., et al. “Intraoperative compliance profiles and regional lung ventilation improve with increasing positive end-expiratory pressure”. Acta Anaesthesiologica Scandinavica 60.9 (2016):1241-1250. 
  32. Hemmes SNT., et al. “High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): A multicentre randomised controlled trial”. Lancet 384.9942 (2014): 495-503. 
  33. Anaesthesiology WC for the PCG of the ProVeN (PROVEnet) for the CTN of the ES of. “Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial”. Journal of the American Medical Association 321.23 (2019): 2292-2305. 
  34. Young CC., et al. “Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations”. British Journal of Anaesthesia 123.6 (2019): 898-913. 
  35. Stolmeijer R., et al. “A Systematic Review of the Effects of Hyperoxia in Acutely Ill Patients: Should We Aim for Less?” BioMed Research International (2018): 7-9. 
  36. Güldner A., et al. “Intraoperative Protective Mechanical Ventilation for Prevention of Postoperative Pulmonary Complications”. Anesthesiology 123.3 (2015): 692-713. 


Citation: Sen. S. “Mechanical Ventilation in the Operating Room: Evidence and Current Practice". Acta Scientific Medical Sciences 4.2 (2020): 186-189.


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