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Avoid hyperventilation ( ETCO 2 = 40-50 mm Hg ), patients “live” at a higher PaCO 2 Hypercapnia (PaCO 2 = 50 mmHg) improves tissue oxygenation Hager et al: Anesth Analg 2006; 103: 677-81 Fleischmann et al: Anesthesiology 2006; 104: 944-9 Optimal lung protective ventilatory strategy
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Avoid hyperventilation (ETCO2 = 40-50 mm Hg), patients “live” at a higher PaCO2 Hypercapnia (PaCO2 = 50 mmHg) improves tissue oxygenation Hager et al: Anesth Analg 2006; 103: 677-81 Fleischmann et al: Anesthesiology 2006; 104: 944-9 Optimal lung protective ventilatory strategy Low tidal volumes (6-8 mL/kg, IBW) PEEP (5-10 cm H2O) Recruitment maneuver (40 cm H2O for 40 s) Gertler & Joshi: Advances in Anesthesia 2010 Futier E et al: Anesthesiology 2010; 113: 1310-9 Ventilatory Management: Alveolar Recruitment