Lung recruitment maneuver: Difference between revisions

Revision as of 06:14, 13 April 2016

Controversial in terms of safety and efficacy
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, 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

Authors:

@@ Line 14: / Line 14: @@
 *Goals to recruit alveoli and maintain with PEEP to prevent cyclic collapse
 **Improving hypoxemia, perhaps also improving respiratory acidosis
-**Decrease [[Ventilator-induced lung injury]]
+**Decrease [[ventilator-induced lung injury]]
 ==Procedure==