PULMONARY atelectasis in the anesthetized and mechanically ventilated patient was first suggested 1963 and demonstrated using computed tomography in the 1980s. Many studies have since then been performed, both during anesthesia in essentially lung-healthy subjects and in mechanically ventilated patients with acute respiratory failure. In 1967 another morphological phenomenon was proposed in both healthy and sick lungs—that is, airway closure. It was initially demonstrated by indirect means using gas dilution techniques. Recently, airway closure could also be more directly visualized in anesthetized rabbits using a synchrotron radiation technique, seen mainly in the 18th generation of airways. This “classic” airway closure occurs when pressure outside the airway is higher than inside. The outside pressure equals, more or less, the pleural pressure and increases down the lung, primarily related to the weight of...

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