The
effect of non-invasive mechanical ventilation in postoperative respiratory
failure
Ezgi
ÖZYILMAZ1, Akın KAYA2
1 Department
of Chest Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey,
2 Department
of Chest Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey.
SUMMARY
The
effect of non-invasive mechanical ventilation in postoperative respiratory
failure
Postoperative
respiratory failure is related with the highest mortality and morbidity among
all perioperative complications. The most common underlying mechanism of
postoperative respiratory failure is the development of atelectasis.
Anaesthesia, medications which cause respiratory depression, high FiO2
use, postoperative pain and disruption of muscle forces due to surgery leads to
decrease in functional residual capacity and results in atelectasis formation.
Atelectasis causes severe hypoxemia due to ventilation, perfusion mismatch,
shunt and increased peripheral vascular resistance. Intrathoracic positive
pressure is an effective therapeutic option in both prevention and treatment of
atelectasis. Non-invasive mechanical ventilation is related with a lower
mortality and morbidity rate due to lack of any potential complication risks of
endotracheal intubation. Non-invasive mechanical ventilation can be applied as
prophylactic or curative. Both of these techniques are related with lower
reintubation rates, nasocomial infections, duration of hospitalization and
mortality in patients with postoperative respiratory failure. The differences
of this therapy from standard application and potential complications should be
well known in order to improve prognosis in these group of patients. The
primary aim of this review is to underline the pathogenesis of postoperative
respiratory failure. The secondary aim is to clarify the optimum method, effect
and complications of non-invasive mechanical ventilation therapy under the
light of the studies which was performed in specific patient groups.
Key
Words: Postoperative respiratory failure, non-invasive
mechanical ventilation.
Received: 20/07/2011 - Accepted: 21/07/2011
Address for Correspondence:
Dr.
Ezgi ÖZYILMAZ,
Çukurova
Üniversitesi Tıp Fakültesi Balcalı Hastanesi,
Göğüs
Hastalıkları Anabilim Dalı,
ADANA
- TURKEY
e-mail: ezgiozyilmaz@hotmail.com
