Postoperative remote lung injury and its impact on surgical outcome

BMC Anesthesiol. 2019 Mar 4;19(1):30. doi: 10.1186/s12871-019-0698-6.

Abstract

Postoperative remote lung injury is a complication following various surgeries and is associated with short and long-term mortality and morbidity. The release of proinflammatory cytokines, damage-associated molecular patterns such as high-mobility group box-1, nucleotide-biding oligomerization domain (NOD)-like receptor protein 3 and heat shock protein, and cell death signalling activation, trigger a systemic inflammatory response, which ultimately results in organ injury including lung injury. Except high financial burden, the outcome of patients developing postoperative remote lung injury is often not optimistic. Several risk factors had been classified to predict the occurrence of postoperative remote lung injury, while lung protective ventilation and other strategies may confer protective effect against it. Understanding the pathophysiology of this process will facilitate the design of novel therapeutic strategies and promote better outcomes of surgical patients. This review discusses the cause and pathology underlying postoperative remote lung injury. Risk factors, surgical outcomes and potential preventative/treatment strategies against postoperative remote lung injury are also addressed.

Keywords: Cytokine; Pathophysiology; Remote lung injury; Risk factor; Therapeutic strategy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Cytokines / metabolism
  • Humans
  • Lung Injury / epidemiology
  • Lung Injury / etiology*
  • Lung Injury / physiopathology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology*
  • Protective Factors
  • Respiration, Artificial / methods*
  • Risk Factors

Substances

  • Cytokines