Lung recruitment maneuver: Difference between revisions
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==Background== | ==Background== | ||
*Controversial in terms of safety and efficacy | *Controversial in terms of safety and efficacy | ||
*Multiple methods reported | |||
*Severe ARDS in which PaO2 recalcitrant to maximal ventilator settings, APRV, PCV | *Severe ARDS in which PaO2 recalcitrant to maximal ventilator settings, APRV, PCV | ||
*Biotrauma and cytokine release occur due to: | *Biotrauma and cytokine release occur due to: | ||
Revision as of 06:21, 13 April 2016
Background
- Controversial in terms of safety and efficacy
- Multiple methods reported
- Severe ARDS in which PaO2 recalcitrant to maximal ventilator settings, APRV, PCV
- Biotrauma and cytokine release occur due to:
- Dependent/chronic collapse injury of airways throughout TV
- Intermediate/cyclic collapse causing shear injury atelectrauma with each breath
- Least dependent areas inflated throughout TV are also easily hyperinflated causing volutrauma and barotrauma in:
- TVs > 6 cc/kg
- Pplat > 30-35 cmH2O
- Derecruitment of alveoli occurs due to[1]:
- Standard low TV ventilation in ARDS
- Insufficient PEEP
- High FiO2 absorptive atelectasis
- Goals to recruit alveoli and maintain with PEEP to prevent cyclic collapse
- Improving hypoxemia, perhaps also improving respiratory acidosis
- Decrease ventilator-induced lung injury
Procedure
See Also
References
- ↑ Nickson C. Lung Recruitment Maneuvers. 21 Sept 2014. http://lifeinthefastlane.com/ccc/recruitment-manoeuvres-in-ards/