Editorial Views  |   October 2019
Pre-emergence Oxygenation and Postoperative Atelectasis
Author Notes
  • From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
  • This editorial accompanies the article on p. 809.
    This editorial accompanies the article on p. 809.×
  • Accepted for publication June 3, 2019.
    Accepted for publication June 3, 2019.×
  • Address correspondence to Dr. Domino: kdomino@uw.edu
Article Information
Editorial / Respiratory System
Editorial Views   |   October 2019
Pre-emergence Oxygenation and Postoperative Atelectasis
Anesthesiology 10 2019, Vol.131, 771-773. doi:https://doi.org/10.1097/ALN.0000000000002875
Anesthesiology 10 2019, Vol.131, 771-773. doi:https://doi.org/10.1097/ALN.0000000000002875
General anesthesia profoundly affects pulmonary function with a decrease in resting lung volume due to loss of muscle tone.1  Functional residual capacity decreases irrespective of whether ventilation is controlled or spontaneous, whether anesthesia is inhaled or intravenous (with the exception of ketamine), or whether muscle relaxants are administered.1  As functional residual capacity falls below closing capacity, airway closure and atelectasis occurs, especially in dependent lung regions. More than 20 yr ago, computed tomography scanning in humans demonstrated atelectasis formation with induction of general anesthesia.2  In this issue of Anesthesiology, Östberg et al.3  utilized computed tomography scanning to investigate whether removal of positive end-expiratory pressure (PEEP) before pre-emergence oxygenation would reduce postoperative atelectasis in humans. The study by Östberg et al. 3  is important because it investigates the effects of anesthesia, PEEP, and pre-emergence oxygenation on normal human respiratory physiology, without the influence of patient disease.