Abstract: Perioperative lung injury (PLI) represents a prevalent clinical complication. Although significant advancements have been made in elucidating its pathogenesis in recent years, the development of effective early diagnostic and intervention strategies remains limited in clinical practice. This limitation is primarily attributed to the complexity of the factors inducing PLI and the heterogeneity of its pathological processes. Current research underscores the pivotal roles of immune⁃inflammatory responses and cellular stress states in the initiation and progression of PLI. This article provides a comprehensive review of  the latest advancements in PLI⁃related immune recognition, organelle dysfunction, programmed cell death, and regulatory mechanisms of repair. The aim is to furnish theoretical support for the exploration of perioperative lung protection strategies and the development of novel intervention approaches.

Key words: Perioperative lung injury, Immune inflammation, Stress response, Cell death, Inflammatory repair