Lung Ventilation Protocol Minimizes Injury During Surgery!

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Lung Ventilation Protocol Minimizes Injury During Lung Cancer Surgery

Last Updated: 2009-04-06 17:53:14 -0400 (Reuters Health)

NEW YORK (Reuters Health) - A revised lung ventilation approach reduces the chances of acute lung injury in patients undergoing resection for lung cancer, Swiss researchers report in a March 24th on-line publication in Critical Care.

"We have shown that the adoption and implementation of a protective lung ventilation protocol considerably reduces the risk for the development of an acute lung injury syndrome," lead investigator Dr. Marc Licker told Reuters Health.

"Given the fact that acute lung injury has become the leading cause of death among patients who are operated on for lung cancer," he added, "a significant number of lives can be saved by adopting this ventilatory protocol."

Dr. Licker of the University of Geneva and colleagues note that the protocol involves using low tidal volume, limitation of maximal pressure ventilation and adding end-expiratory positive pressure along with recruitment maneuvers.

To evaluate the effectiveness of the approach, the researchers examined data from 533 patients who underwent surgery before implementation of the protocol and 558 who underwent surgery after the introduction of the protocol.

After the introduction of the protocol, the incidence of acute lung injury fell from 3.7% to 0.9% and atelectasis from 8.8% to 5.0%. There also were fewer ICU admissions (9.4% versus 2.5%) and hospital stays were shorter (14.5 versus 11.8 days). After adjusting for baseline characteristics, the "open-lung protocol" was still significantly associated with a lower risk of acute lung injury.

Given these findings, the researchers conclude that "traditional intraoperative ventilatory settings can be harmful; therefore new guidelines should be proposed."

Crit Care 2009;13:R41.

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