Intraoperative mechanical ventilation management in COPD: A state of the art review

Abstract

Highlights • COPD is a prevalent condition among surgical patients and is recognized as a significant risk factor for negative postoperative outcomes.• Intraoperative mechanical ventilation is a crucial strategy for managing COPD, but it may exacerbate COPD-related physiological dysfunctions if not appropriately optimized.• The available evidence supports adopting a personalized approach to intraoperative ventilation that is guided by the patient’s physiological parameters, rather than by uniform ventilatory targets.• Patient‑centered, individualized ventilation plans, integrated within a broader perioperative plan, hold the most promising potential for reducing postoperative complications and improving surgical outcomes in patients with COPD.• Future studies should focus on COPD-specific research that considers the severity of the disease, phenotypic variability, baseline gas exchange abnormalities, and different ventilation approaches.