Ventilation

Ihe accepted rule in some centers is that ventilation is avoided following lung resection since the bronchial suture line may leak. This position is difficult to justify when one considers that lobar bronchi suture lines are routinely tested to be watertight at a pressure of 35-40 cmH 2O intraoperatively. Of more importance is the increased incidence of infection in intubated patients, which may impair stump healing, and overdistention of the contralateral lung with possible mediastinal shift from positive-pressure ventilation. Elective postoperative ventilation should be avoided for pulmonary resections. Short-term planned ventilation may help patients who are frail and likely to become exhausted after complex lung and chest wall resections.

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