Protecting the lung Strategies and outcomes in surgical and critically ill patients

Mechanical ventilation is essential to ensure adequate gas exchange during general anesthesia for surgery and is life–saving in critically ill patients with acute respiratory failure. However, it has become clear that mechanical ventilation itself can contribute to lung injury.
The first part of this thesis focuses on lung–protective ventilation strategies in the operating room. We explore geo–economic differences in the risk and incidence of postoperative pulmonary complications (PPCs), and assess the predictive value of the intraoperative air–test for PPCs. Furthermore, we present the results of a large international randomized clinical trial comparing individualized high PEEP to standard low PEEP during open abdominal surgery on the incidence of PPCs.
The second part of this thesis addresses lung–protective ventilation in critically ill patients with COVID–19 in the intensive care unit. We investigate whether age influences ventilation management and outcomes, and compare ventilation practices and clinical outcomes between the first and second pandemic waves.