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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2019

Open Access 01-12-2019 | Acute Respiratory Distress-Syndrome | Review

Perioperative anaesthetic management of patients with or at risk of acute distress respiratory syndrome undergoing emergency surgery

Authors: Denise Battaglini, Chiara Robba, Patricia Rieken Macêdo Rocco, Marcelo Gama De Abreu, Paolo Pelosi, Lorenzo Ball

Published in: BMC Anesthesiology | Issue 1/2019

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Abstract

Patients undergoing emergency surgery may present with the acute respiratory distress syndrome (ARDS) or develop this syndrome postoperatively. The incidence of ARDS in the postoperative period is relatively low, but the impact of ARDS on patient outcomes and healthcare costs is relevant Aakre et.al (Mayo Clin Proc 89:181-9, 2014).
The development of ARDS as a postoperative pulmonary complication (PPC) is associated with prolonged hospitalisation, longer duration of mechanical ventilation, increased intensive care unit length of stay and high morbidity and mortality Ball et.al (Curr Opin Crit Care 22:379-85, 2016). In order to mitigate the risk of ARDS after surgery, the anaesthetic management and protective mechanical ventilation strategies play an important role. In particular, a careful integration of general anaesthesia with neuraxial or locoregional techniques might promote faster recovery and reduce opioid consumption. In addition, the use of low tidal volume, minimising plateau pressure and titrating a low-moderate PEEP level based on the patient’s need can improve outcome and reduce intraoperative adverse events. Moreover, perioperative management of ARDS patients includes specific anaesthesia and ventilator settings, hemodynamic monitoring, moderately restrictive fluid administration and pain control.
The aim of this review is to provide an overview and evidence- and opinion-based recommendations concerning the management of patients at risk of and with ARDS who undergo emergency surgical procedures.
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Metadata
Title
Perioperative anaesthetic management of patients with or at risk of acute distress respiratory syndrome undergoing emergency surgery
Authors
Denise Battaglini
Chiara Robba
Patricia Rieken Macêdo Rocco
Marcelo Gama De Abreu
Paolo Pelosi
Lorenzo Ball
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2019
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-019-0804-9

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