Atelectasis Prevention in Anaesthesia and Intensive Care

Abstract

Pulmonary atelectasis is a common problem in the field of anaesthesia. If left untreated, it can cause severe complications that ultimately increases the risk of mortality. Due to the common incidence of atelectasis, every patient undergoing anaesthesia should be offered some sort of prophylaxis and treatment. Hence, this literature review aims to investigate the methods of prevention and treatment of atelectasis. There are many options to treat and prevent atelectasis. The initial risk assessment classifications, such as ASA and ARISCAT, could be used to assess per and post operative risk of pulmonary complications such as atelectasis. By recognizing the risk factors the anaesthetist can include preventative measures early in the anaesthesia and rehabilitation plan. Induction of anaesthesia using a lower FiO2 has good effect on atelectasis but also shorten apnoea time. Ultimately, it should not be used routinely for induction of anaesthesia. Recruitment manoeuvres has proven to be effective in reducing atelectasis, especially if used together with a PEEP. The usage of PEEP alone will recruit lesser lung tissue and its effect wear off quickly when the PEEP is removed. Lung physiotherapy and early mobilisation has proven to be very effective in treating and preventing atelectasis and should always be implemented into the patient´s treatment plan.