Intraoperative hypoxaemia and postoperative respiratory complications remain the challenges of modern anaesthetic practice. Anaesthesia causes both depression of respiratory centres and profound changes of respiratory mechanics. Most anaesthetized patients consequently require mechanical ventilation and supplemental oxygen. Recent data suggest that intraoperative respiratory management of a patient can affect postoperative outcome. In this review, we briefly describe the mechanisms responsible for the impairment of intraoperative gas exchange and provide guidelines to prevent or manage hypoxaemia. Moreover, we discuss several aspects of mechanical ventilation that can be employed to improve patients' outcome.
aDepartment of Anaesthesia and Intensive Care Medicine, CHU de Liège, University of Liège, Liège, Belgium
bAnaesthesia and Intensive Care Unit, Clinique Notre-Dame de Grâce, Gosselies Hospital, Gosselies, Belgium
Accepted 9 June, 2008
Correspondence to Dr Gregory A. Hans, Department of Anaesthesia and Intensive Care Medicine, CHU de Liège, Domaine du Sart Tilman, B-4000 Liège, Belgium Tel: +32 4 3667180; fax: +32 4 3667636; e-mail: G.Hans@skynet.be