RESUMO
La ventilación mecánica en cirugía torácica ha sufrido cambios significativos en los últimos años debido a la implantación de la ventilación protectora. Esta revisión analizará las estrategias ventilatorias recientes en la ventilación unipulmonar. Se realizó una búsqueda en MEDLINE utilizando el término MeSH «One-Lung Ventilation», incluyendo ensayos clínicos aleatorios, metaanálisis, revisiones y revisiones sistemáticas publicadas en los últimos 6 años. La búsqueda se realizó el 21 de marzo de 2017. Inicialmente se encontraron un total de 75 artículos. Después de la revisión del título y resumen se incluyeron 14 artículos. La ventilación protectora no es simplemente sinónimo de ventilación de bajo volumen tidal, sino que también incluye el uso rutinario de PEEP y la maniobra de reclutamiento alveolar. Las nuevas técnicas siguen discutiéndose, a saber: ajuste de PEEP, ratio inspiración:espiración, tipo ideal de anestesia durante ventilación unipulmonar y ventilación hipercápnica (AU)
Mechanical ventilation in thoracic surgery has undergone significant changes in recent years due to the implementation of the protective ventilation. This review will analyze recent ventilatory strategies in one-lung ventilation. A MEDLINE research was performed using Mesh term "One-Lung Ventilation" including randomized clinical trials, metanalysis, reviews and systematic reviews published in the last 6 years. Search was performed on 21st March 2017. A total of 75 articles were initially found. After title and abstract review 14 articles were included. Protective ventilation is not simply synonymous of low tidal volume ventilation, but it also includes routine use of PEEP and alveolar recruitment maneuver. New techniques are still in discussion namely PEEP adjustment, ratio inspiration:expiration, ideal type of anesthesia during one-lung ventilation and hypercapnic ventilation (AU)
Assuntos
Humanos , Respiração Artificial/métodos , Pressão Positiva Contínua nas Vias Aéreas/métodos , Procedimentos Cirúrgicos Torácicos/métodos , Anestesia/métodos , Prática Clínica Baseada em Evidências , Fatores de ProteçãoRESUMO
Mechanical ventilation in thoracic surgery has undergone significant changes in recent years due to the implementation of the protective ventilation. This review will analyze recent ventilatory strategies in one-lung ventilation. A MEDLINE research was performed using Mesh term "One-Lung Ventilation" including randomized clinical trials, metanalysis, reviews and systematic reviews published in the last 6 years. Search was performed on 21st March 2017. A total of 75 articles were initially found. After title and abstract review 14 articles were included. Protective ventilation is not simply synonymous of low tidal volume ventilation, but it also includes routine use of PEEP and alveolar recruitment maneuver. New techniques are still in discussion namely PEEP adjustment, ratio inspiration:expiration, ideal type of anesthesia during one-lung ventilation and hypercapnic ventilation.
