4 Anaesthesia and patient blood management

4.3 Type of Ventilation

Positive pressure ventilation has been associated with increased intraoperative blood loss compared with spontaneous ventilation during THJR under general anaesthesia.279,282 This effect is possibly due to the impact that positive intrathoracic pressure has on decreasing venous return and increasing venous pressure at the operative site. Likewise, minimising expiratory resistance by manipulating ventilator parameters and optimising reactive airway disease should assist venous return and may reduce blood loss.291 The impact that spontaneous ventilation has on reducing transfusion seems to be unclear.