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Prevention and Management of Perioperative Respiratory Failure
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Prevention and Management of Perioperative Respiratory Failure

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 17478

Special Issue Editor

Prof. Dr. Gilda Cinnella

E-Mail Website
Guest Editor
Department of Anesthesia and Intensive Care, University of Foggia, 71122 Foggia, Italy
Interests: intensive care medicine; anesthesiology; cardiopulmonary resuscitation; critical care medicine; patient blood management; perioperative medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Each year, a substantial number of patients are at high risk of postoperative respiratory failure, pulmonary complications or both. The genesis and the severity of postoperative respiratory failure can be multifactorial, depending on the baseline condition of the patients, surgical trauma, differences in anesthesia practice, and postoperative care. The increased number of patients with limited physiological reserve undergoing major surgery unavoidably increases the complexities in the management. Recognition and management of postoperative pulmonary complications require a multimodal approach focused on preventing, recognizing, and starting treatment promptly. Accordingly, a correct perioperative strategy should include risk stratification, preoperative optimization, intraoperative techniques aimed at minimizing respiratory impairments, and adequate, individualized postoperative support.

This Special Issue of the Journal of Clinical Medicine will contain original and review papers concerning anesthesia, analgesia, and intensive care and focused on improving the standard of care in the prevention and management of perioperative respiratory failure. Researchers involved in the field are invited to contribute with their significant expertise; additionally, the issue will include invited contributions from world-leading experts, who will develop a "Best Evidence in Prediction, Prevention, and Management of Postoperative Pulmonary Complication" series.

Prof. Dr. Gilda Cinnella
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • respiratory failure
  • pulmonary complications
  • risk stratification
  • intraoperative techniques
  • preoperative optimization
  • perioperative strategy
  • perioperative monitoring
  • postoperative support

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Published Papers (3 papers)

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Review

17 pages, 478 KiB  
Review
Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review
by Alberto Fogagnolo, Federica Montanaro, Lou’i Al-Husinat, Cecilia Turrini, Michela Rauseo, Lucia Mirabella, Riccardo Ragazzi, Irene Ottaviani, Gilda Cinnella, Carlo Alberto Volta and Savino Spadaro
J. Clin. Med. 2021, 10(12), 2656; https://doi.org/10.3390/jcm10122656 - 16 Jun 2021
Cited by 12 | Viewed by 4815
Abstract
Mechanical ventilation (MV) is still necessary in many surgical procedures; nonetheless, intraoperative MV is not free from harmful effects. Protective ventilation strategies, which include the combination of low tidal volume and adequate positive end expiratory pressure (PEEP) levels, are usually adopted to minimize [...] Read more.
Mechanical ventilation (MV) is still necessary in many surgical procedures; nonetheless, intraoperative MV is not free from harmful effects. Protective ventilation strategies, which include the combination of low tidal volume and adequate positive end expiratory pressure (PEEP) levels, are usually adopted to minimize the ventilation-induced lung injury and to avoid post-operative pulmonary complications (PPCs). Even so, volutrauma and atelectrauma may co-exist at different levels of tidal volume and PEEP, and therefore, the physiological response to the MV settings should be monitored in each patient. A personalized perioperative approach is gaining relevance in the field of intraoperative MV; in particular, many efforts have been made to individualize PEEP, giving more emphasis on physiological and functional status to the whole body. In this review, we summarized the latest findings about the optimization of PEEP and intraoperative MV in different surgical settings. Starting from a physiological point of view, we described how to approach the individualized MV and monitor the effects of MV on lung function. Full article
(This article belongs to the Special Issue Prevention and Management of Perioperative Respiratory Failure)
17 pages, 2557 KiB  
Review
Should Lung-Sparing Surgery Be the Standard Procedure for Malignant Pleural Mesothelioma?
by Yoshinobu Ichiki, Hidenori Goto, Takashi Fukuyama and Kozo Nakanishi
J. Clin. Med. 2020, 9(7), 2153; https://doi.org/10.3390/jcm9072153 - 8 Jul 2020
Cited by 7 | Viewed by 5407
Abstract
Background: Surgical procedures for malignant pleural mesothelioma (MPM) include extrapleural pneumonectomy (EPP), extended pleurectomy/decortication (P/D) and P/D. EPP has been applied to MPM for a long time, but the postoperative status is extremely poor due to the loss of one whole lung. We [...] Read more.
Background: Surgical procedures for malignant pleural mesothelioma (MPM) include extrapleural pneumonectomy (EPP), extended pleurectomy/decortication (P/D) and P/D. EPP has been applied to MPM for a long time, but the postoperative status is extremely poor due to the loss of one whole lung. We compared the mortality, morbidity and median survival time (MST) of lung-sparing surgery (extended P/D or P/D) and lung-sacrificing surgery (EPP) for MPM by performing a systematic review. Methods: We extracted the number of events and patients from the literature identified in electronic databases. Ultimately, 15 reports were selected, and 2674 MPM patients, including 1434 patients undergoing EPP and 1240 patients undergoing extended P/D or P/D, were analyzed. Results: Our systematic review showed that lung-sparing surgery was significantly superior to lung-sacrificing surgery in both the surgical-related mortality (extended P/D vs. EPP: 3.19% vs. 7.65%, p < 0.01; P/D vs. EPP: 1.85% vs. 7.34%, p < 0.01) and morbidity (extended P/D vs. EPP: 35.7% vs. 60.0%, p < 0.01; P/D vs. EPP: 9.52% vs. 20.89%, p < 0.01). Lung-sparing surgery was not inferior to EPP in terms of MST. Conclusion: Although no prospective randomized controlled trial has been conducted, it may be time to change the standard surgical method for MPM from lung-sacrificing surgery to lung-sparing surgery. Full article
(This article belongs to the Special Issue Prevention and Management of Perioperative Respiratory Failure)
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29 pages, 686 KiB  
Review
Recognizing Risks and Optimizing Perioperative Care to Reduce Respiratory Complications in the Pediatric Patient
by Chinyere Egbuta and Keira P. Mason
J. Clin. Med. 2020, 9(6), 1942; https://doi.org/10.3390/jcm9061942 - 22 Jun 2020
Cited by 36 | Viewed by 6440
Abstract
There have been significant advancements in the safe delivery of anesthesia as well as improvements in surgical technique; however, the perioperative period can still be high risk for the pediatric patient. Perioperative respiratory complications (PRCs) are some of the most common critical events [...] Read more.
There have been significant advancements in the safe delivery of anesthesia as well as improvements in surgical technique; however, the perioperative period can still be high risk for the pediatric patient. Perioperative respiratory complications (PRCs) are some of the most common critical events that can occur in pediatric surgical patients and they can lead to increased length of hospitalization, worsened patient outcomes, and higher hospital and postoperative costs. It is important to determine the various factors that put pediatric patients at increased risk of PRCs. This will allow for more detailed and accurate informed consent, optimized perioperative management strategy, improved allocation of clinical resources, and, hopefully, better patient experience. There are only a few risk prediction models/scoring tools developed for and validated in the pediatric patient population, but they have been useful in helping identify the key factors associated with a high likelihood of developing PRCs. Some of these factors are patient factors, while others are procedure-related factors. Some of these factors may be modified such that the patient’s clinical status is optimized preoperatively to decrease the risk of PRCs occurring perioperatively. Fore knowledge of the factors that are not able to be modified can help guide allocation of perioperative clinical resources such that the negative impact of these non-modifiable factors is buffered. Additional training in pediatric anesthesia or focused expertise in pediatric airway management, vascular access and management of massive hemorrhage should be considered for the perioperative management of the less than 3 age group. Intraoperative ventilation strategy plays a key role in determining respiratory outcomes for both adult and pediatric surgical patients. Key components of lung protective mechanical ventilation strategy such as low tidal volume and moderate PEEP used in the management of acute respiratory distress syndrome (ARDS) in pediatric intensive care units have been adopted in pediatric operating rooms. Adequate post-operative analgesia that balances pain control with appropriate mental status and respiratory drive is important in reducing PRCs. Full article
(This article belongs to the Special Issue Prevention and Management of Perioperative Respiratory Failure)
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