Images of Alveolar Recruitment

Abstract

The knowledge of Mechanical Ventilation injury-associated syndrome gave rise to immediate studies setting forth new ventilation strategies and modes and the design of new-generation ventilators, which would be able to guarantee the oxigenation metabolic needs,

wilthout aditional injury to the patient primary disease, being the base of Protective Ventilation. The alveolar recruitement becomes the corner- stone of the Protective Ventilation in the Adult Respiratory Distress Syndrome by opening the congestive and atelectatic alveoli to prevent the alveolar movement. At the same time it improves the ventilation-perfusion relationship V/Q, and eases the oxigenation of arterial blood; allowing this way, decrease the concentration of oxigen in the inspired air. In order to evaluate optimal PEEP level that guarantees maximum alveolar recruitment and the tidal volume that avoid the over-distension of the most distensible alveoli. The interpretation of airway pressure curves/ Dynamic volume P/V, obtained by means of a graphic depiction monitor head of bed is suggested.

X-ray filming has been obtained to show optimal alveolar recruitment with the application of PEEP 2 cm H2O superior to the inferior point of inflexion of the P/V curve, above all in palients admitted to hospital with ARDS secundary to extrapulmonary pathologies.

The imaging of the alveolar recruitment in patients admitted to hospital at the Intensive Care Unit of the Ciego de Avila Provincial Hospital is shown in this research paper.

Tomography corresponds with unpublished images, personal courtesy of Professor Marcello Britto Passos Amato, Intensive Respiratory Care Unit, University of Sao Paulo, Brazil.