Pulmonale funktionsstörungen nach extrakorporaler zirkulation - Spielt das lungenmanagement während EKZ eine rolle?

Postoperative pulmonary insufficiency is a common complication of cardiopulmonary bypass and is associated with atelectasis and pulmonary endothelial dysfunction. Prophylactic and therapeutic options include modifications of the extracorporeal circulation system as well as modifications of the systemic inflammatory response induced by extracorporeal circulation. Only a few studies address the intraoperative management of the lungs. They consume about 5% of the whole body oxygen uptake during extracorporeal circulation. Lung tissue hypoxia, hyperoxia and hypocapnia should be avoided. The application of a continuous positive airway pressure has been shown to improve post-bypass lung function. Of special importance is a sufficient lung recruitment maneuver before termination of cardiopulmonary bypass.