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Post-operative ventilatory dysfunction management in the ICU 

Post-operative ventilatory dysfunction management in the ICU
Post-operative ventilatory dysfunction management in the ICU

Paolo Chiarandini

and Giorgio Della Rocca

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date: 05 July 2022

Alterations in respiratory function and gas exchanges are frequently seen in patients during anaesthesia and in the post-operative period. Mechanical ventilation and drugs such as neuromuscular blocking agents can alter normal function of the respiratory system and cause damage to lungs. Protective ventilation strategies should always be adopted intra-operatively in mechanically-ventilated patients. A neuromuscular monitoring-guided use of decurarizating agents and post-operative adequate analgesia techniques are recommended to avoid post-operative residual curarization and pain. Pneumonia is the most frequent infective complication, but at the moment there are no recommended clinical tools (scoring systems) to identify patients at high. A fast-track surgical approach and early can decrease the risk. Early mobilization and prophylactic low molecular weight heparins use have a well-documented efficacy on prevention of pulmonary embolism. There is still no general consensus on the widespread use of early NIV in post-operative patients, although in selected high-risk patients it could help respiratory recovery and reduce complications.

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