The prevention of postoperative respiratory complications in lung surgery

INTRODUCTION. Development of ARDS, postoperative pneumonia and respiratory deficiency with varying degree of severity are common and dangerous complications of toracal surgeries. Intra- and postoperative atelectasis build the morphological basis of the development of these complications.Applying high frequency jet ventilation during postoperative period also optimizes ventilation/perfusion ratio and prevents development of atelectasis and ARDS. METHODS. We compared two groups of patients that underwent lung surgery. In the first group CMV was applied, in the second group – HFJV. The groups of patients are comparable in terms of age, basic pathology and type of surgical intervention. Atelectasis prophylaxis and therapy included non-invasive HFJV in CPAP (continuous positive airway pressure) emulation regime that was conducted by 10-minute sessions 4-6 times a day during the first 3 days after surgery and teaching the patients to autonomously use Hering-Breuer Reflex for cough stimulation. RESULTS. In the first group development of discoid atelectasis in the first 24 hours could be observed in 62 patients (19.8%), in the second group – in 18 (5.8%). CONCLUSIONS. Application high frequency jet ventilation during surgery and immediate postoperative period enabled to reduce the frequency of postoperative discoid atelectasis developing in the first 24 hours by three times and to avoid development of ARDS and postoperative pneumonia.