<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1726-6718</journal-id>
<journal-title><![CDATA[Revista Cubana de Anestesiología y Reanimación]]></journal-title>
<abbrev-journal-title><![CDATA[Rev cuba anestesiol reanim]]></abbrev-journal-title>
<issn>1726-6718</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1726-67182022000100006</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Estrategias de ventilación protectora en cirugía cardiovascular]]></article-title>
<article-title xml:lang="en"><![CDATA[Protective ventilation strategies in cardiovascular surgery]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alonso Valdés]]></surname>
<given-names><![CDATA[Jorge Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Falcón Guerra]]></surname>
<given-names><![CDATA[Miriam]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández Román]]></surname>
<given-names><![CDATA[Marvin]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[de Arazoza Hernández]]></surname>
<given-names><![CDATA[Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Nodal Leyva]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Saínz Cabrera]]></surname>
<given-names><![CDATA[Humberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Cardiología y Cirugía Cardiovascular  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Docente Clínico Quirúrgico Dr. &#8220;Salvador Allende&#8221;  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2022</year>
</pub-date>
<volume>21</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1726-67182022000100006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1726-67182022000100006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1726-67182022000100006&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La alteración en el intercambio gaseoso es una complicación de la cirugía cardíaca con circulación extracorpórea. La causa de este deterioro es multifactorial. Durante la derivación, ambos pulmones colapsan y al término de la circulación extracorpórea los pulmones se vuelven a expandir, sin existir una técnica estándar para ello. La aplicación de reclutamiento alveolar durante la anestesia general en este tipo de cirugía mejora la oxigenación arterial.  Objetivo:  Describir aspectos esenciales de fisiopatología de la injuria pulmonar asociada a la ventilación mecánica en procedimientos quirúrgicos cardíacos y el efecto de la ventilación mecánica protectora perioperatoria como estrategia para prevenirla.  Método:  Se realizó una búsqueda de la literatura publicada durante el período comprendido entre enero de 1990 y diciembre de 2020 que hiciera referencia a las estrategias de ventilación mecánica protectora en cirugía cardiovascular.  Resultados:  La evidencia experimental y clínica sugiere que los bajos volúmenes corrientes de ventilación pulmonar y la aplicación por un corto período del aumento de las presiones inspiratorias, conocidas como &#8220;maniobras de reclutamiento&#8221; seguidas de la aplicación de presión positiva al final de la espiración para mantener los alveolos reclutados abiertos, incrementan la capacidad residual funcional y reducen la injuria pulmonar asociada a la ventilación mecánica. Estas recomendaciones han sido extrapoladas de estudios retrospectivos realizados en otro tipo de poblaciones.  Conclusiones:  No existe evidencia contundente de que esta estrategia disminuya la respuesta proinflamatoria, mejore la función pulmonar posoperatoria y disminuya la mortalidad perioperatoria, cuando se compara con la ventilación convencional.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  The alteration in gas exchange is a complication of cardiac surgery with extracorporeal circulation. The cause of this deterioration is multifactorial. During the shunt, both lungs collapse and at the end of the extracorporeal circulation the lungs expand again, without a standard technique for it. The application of alveolar recruitment during general anesthesia in this type of surgery improves arterial oxygenation. Multiple strategies are used and have as a reference the extracorporeal circulation and its contribution to the pulmonary and systemic inflammatory response. This forces the anesthesiologist to understand the pathophysiology of lung injury associated with mechanical ventilation.  Objective:  Describe essential aspects of pathophysiology of pulmonary injury associated with mechanical ventilation in cardiac surgical procedures and the effect of perioperative protective mechanical ventilation as a strategy to prevent it.  Method:  A search of the literature published during the period between January 1990 and December 2020 was carried out that referred to protective mechanical ventilation strategies in cardiovascular surgery.  Results:  Experimental and clinical evidence suggest that low current volumes of pulmonary ventilation and the application for a short period of increased inspiratory pressures, known as "recruitment maneuvers" followed by the application of positive pressure at the end of expiration to keep the recruited alveoli open, increase functional residual capacity and reduce lung injury associated with mechanical ventilation. These recommendations have been extrapolated from retrospective studies conducted in other types of populations.  Conclusions:  There is no strong evidence that this strategy decreases the pro-inflammatory response, improves postoperative lung function and decreases perioperative mortality, when compared to conventional ventilation.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[anestesia]]></kwd>
<kwd lng="es"><![CDATA[cirugía cardiovascular]]></kwd>
<kwd lng="es"><![CDATA[ventilación protectora]]></kwd>
<kwd lng="en"><![CDATA[anesthesia]]></kwd>
<kwd lng="en"><![CDATA[cardiovascular surgery]]></kwd>
<kwd lng="en"><![CDATA[protective ventilation]]></kwd>
</kwd-group>
</article-meta>
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