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Learning objectives
Key points
Target audience

1. Show the relevance of pulmonary complications and the possibility to predict them
- Supporting evidence: pulmonary complications impact on postoperative morbidity and mortality, and represent a burden to health systems
- Supporting evidence: it is possible to identify patients at risk for those complications preoperatively
- Supporting evidence: current intraoperative mechanical ventilation practice may increase the risk of developing those complications

2. Mechanical ventilation can lead to postoperative pulmonary complications
- Supporting evidence: higher airway pressure during anaesthesia induction avoids deterioration of intraoperative lung function
- Supporting evidence: high tidal volume and driving pressure have been unequivocally shown to favour pulmonary complications
- Supporting evidence: the role of PEEP and lung recruitment is still questionable and may pose patients at risk for hemodynamic instability

3. The importance of the immediate postoperative period has been largely neglected
- Supporting evidence: factors that favour deterioration of respiratory function (low airway pressure, high oxygen concentration, residual muscle paralysis etc.) may increase the risk of pulmonary complications
- Supporting evidence: immediate postoperative care, including respiratory support, mobilization and pharmacological measures decrease the risk
​- Supporting evidence: adequate monitoring identify patients at early phase of complications and contribute to avoid failure to rescue

This webinar recording will enable anaesthesiologists to:
- recognize the importance of predicting postoperative pulmonary complications
- identify patients at risk for those complications
- know which ventilator settings are associated with pulmonary complications
- develop strategies to minimize the reduction of intraoperative respiratory function
- choose ventilator settings that protect against those complications while not compromising circulation
- identify factors that lead to reduced postoperative respiratory function during emergence of anaesthesia
- treat those complications and develop monitoring strategies that may avoid failure to rescue

Practical skills to be acquired after attending to this Webinar
The user is able to:
- Objectively stratify patients according to their risk of developing postoperative pulmonary complications, select tidal volumes, positive end-expiratory pressure, driving pressure and decide on applying or not lung recruitment manoeuvres as means to avoid such complications
- Monitor respiratory function and use measures to prevent, treat and avoid progression of pulmonary complications towards even more unfavourable outcomes.

Affective skills acquired after attending to this Webinar
The user is aware of:
- Postoperative pulmonary complications are a major cause of morbidity and mortality
- Risk stratification tools
- That inappropriate mechanical ventilation settings and strategies may increase the risk of developing pulmonary complications
​- That failure identify such patients and to rescue them decreases the chance of survival

  1. Prediction of pulmonary complications helps to identify most vulnerable patients
  2. Appropriate respiratory support in all phases of anaesthesia may reduce the incidence of such complications
  3. Adequate postoperative care and monitoring is key to avoid failure to rescue

Anaesthesiologists who apply mechanical ventilation for general anaesthesia in adult patients.

Webcast on PPC: Patients at risk, Protective Ventilation and Failure to Rescue
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