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Ventilatory management during routine general anaesthesia

Hans, Gregory Aa; Sottiaux, Thierry Mb; Lamy, Maurice La; Joris, Jean La

European Journal of Anaesthesiology (EJA): January 2009 - Volume 26 - Issue 1 - p 1–8
doi: 10.1097/EJA.0b000e000000f1fb

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:

© 2009 European Society of Anaesthesiology