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Vital capacity manoeuvre in general anaesthesia: useful or useless?

Published online by Cambridge University Press:  23 December 2004

W. Oczenski ,
S. Schwarz  and
R. D. Fitzgerald
W. Oczenski
Affiliation:
Vienna City Hospital-Lainz, Ludwig Boltzmann Institute for Economics of Medicine in Anaesthesia and Intensive Care, Department of Anaesthesia and Intensive Care, Vienna, Austria
S. Schwarz
Affiliation:
Vienna City Hospital-Lainz, Ludwig Boltzmann Institute for Economics of Medicine in Anaesthesia and Intensive Care, Department of Anaesthesia and Intensive Care, Vienna, Austria
R. D. Fitzgerald
Affiliation:
Vienna City Hospital-Lainz, Ludwig Boltzmann Institute for Economics of Medicine in Anaesthesia and Intensive Care, Department of Anaesthesia and Intensive Care, Vienna, Austria
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Extract

Summary

As atelectasis occurs in most patients during general anaesthesia and may be one of the major causes for the development of hypoxaemia and nosocomial pneumonia, its prevention may be considered as an important objective in perioperative management. The major causative mechanisms are the loss of respiratory muscle tone, compression and gas absorption. Vital capacity manoeuvres have been proposed as a means to eliminate atelectasis in the vast majority of patients and restore normal pulmonary gas exchange during general anaesthesia. In this review we describe the pathogenesis of atelectasis in the perioperative period and discuss in the light of recent published investigations the suitability of the vital capacity manoeuvre as a tool during general anaesthesia. Reviewing the current literature, a vital capacity manoeuvre during general anaesthesia may only be useful under specific circumstances when mechanical ventilation with a high inspiratory fraction of oxygen is required or during cardiac surgery at the end of cardiopulmonary bypass to reduce the amount of atelectasis and to maintain adequate gas exchange.

Keywords

ANAESTHESIA, GENERAL, postoperative complicationsLUNG DISEASES, atelectasisRESPIRATORY MECHANICS, vital capacityPOSITIVE PRESSURE RESPIRATION, positive end-expiratory pressure
Type
Review
Information
European Journal of Anaesthesiology , Volume 21 , Issue 4 , April 2004 , pp. 253 - 259
Copyright
2004 European Society of Anaesthesiology

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