Use of an alveolar recruitment maneuver
Keywords:
DISTRESS, PEEP, RECLUTAMIENTO ALVEOLARAbstract
A descriptive observational study using an alveolar recruitment maneuver in seven inpatient and artificially ventilated in our intensive care unit with respiratory distress diagnosis in the admission. The maneuver consisted in increase to the double basal value of PEEP during two minutes previous vital signs and ventilatory parameters taken as weel as a gasometry carried out. Peak inspiratory pressure was prefix in 60 cm H20 and tidal volume to 12 ml/kg to avoid overdistention and complications. After two minutes the vital and ventilatory parameters were checked again and another gasometry was done. The parameter that best behare was oxygenation that bettered in all cases, blood pressure lowered but in any case to critical values, heart rate was variable. Peak inspiratory pressure increase in all maneuvers. These was not complication.Downloads
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References
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27. Dreyfuss D, Saumon G. Role of tidal volume, functional residual capacity, and end-inspiratory volume in the development of pulmonary edema following mechanical ventilation. Am Rev Respir Dis 1993; 148:1194-203 .
28. Lapinsky SE, Aubin M, Mehta S, Boiteau P, Slutsky AS. Safety and efficacy of a sustained inflation for alveolar recruitment in adults with respiratory failure. Intensive Care Med 1999; 25: 1297-301.
29. Marini JJ. Recruitment maneuvers to achieve an “open lung” whether and how? Crit Care Med 2001; 29: 1647-8.
30. Grasso S, Mascia L, Del Turco M, Malacarne P, Giunta F, Brochard L, Slutsky AS, Ranieri VM. Effects of recruiting maneuvers in patients with acute respiratory distress syndrome ventilated with protective
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31. Mead J, Takishima T, Leith D. Stress distribution in lungs: a model of pulmonary elasticity. J Appl Physiol 1970; 28:596-608
32. Rothen HU, Sporre B, Engberg G, Wegenius G, Hedenstierna G. Reexpansion of atelectasis during general anaesthesia may have a prolonged effect. Acta Anaesthesiol Scand 1995;39:118–125.
33. Rothen HU, Neumann P, Berglund JE, Valtysson J, Magnusson A, Hedenstierna G. Dynamics of re-expansion of atelectasis during general anaesthesia. Br J Anaesth 1999;82:551–556.
34. Pierson DJ. Barotrauma and bronchopleural fistula. In: Tobin MJ, ed. Principles and practice of mechanical ventilation. New York: McGraw-Hill; 1994:813-36.
35. Tusman G, Böhm S, Tempra A. Effects of Recruitment Maneuver on Atelectasis in Anesthetized Children. Anesthesiology 2003; 98:14-22.
2. Rozman C. Medicina Interna. 14ta ed. Barcelona: Ediciones Harcourt; 2000.
3. Roca Goderich R. Temas de Medicina Interna. t.1. 4ta ed. La Habana: Editorial ECIMED; 2002. [En línea]; Acceso 5 de marzo 2004. URL disponible en: http:// www.Infomed.bvs.libros
4. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet 1967;2:319-23.
5. Downs JB, Klein EF, Modell JH. The effect of incremental PEEP on PaO2 in patients with respiratory failure. Anesth Analg 1973;52:210-5.
6. Douglas ME, Downs JB. Pulmonary function following severe acute respiratory failure and high levels of positive end-expiratory pressure. Chest 1977;71:18-23. .
7. Dreyfuss D, Saumon G. Ventilator-induced lung injury: lessons from experimental studies. Am J Respir Crit Care Med 1998;157:294-323. Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 1998:338:347-54. .
8. Lachmann, B. Open up the lung and keep the lung open. Intensive Care Med.1992, 18: 319-321 .
9. Tusman G, Böhm SH, Vazquez de Anda GF, Do Campo JL, Lachmann B. "Alveolar recruitment strategy" improves arterial oxigenation during general anesthesia. Br J Anaesth 1999; 82:8-13.
10. Tusman G. Función respiratoria durante la anestesia general: estrategia para mejorar el intercambio gaseoso. Rev Arg Anest 2001; 59/4: 245-253
11. Papadakos PJ, Lachmann B. The open lung concept of alveolar recruitment can improbé outcome in respiratory failure and ARDS. The Mountsinai Journal Medicine. 2002; 73-7
12. Pelosi P, Cadringher P, Bottino N, Panigada M, Carrieri F, Riva E, Lissoni A, Gattinonil. Sigh in acute respiratory distress syndrome. Am J Respir Crit Care Med 1999 Mar;159(3):872-80.
13. Lim Ch, Koh Y, Park W, Shim TS. A safe and effective method of lung volume recruitment using conventional mechanical ventilator in patients with early acute respiratory distrés síndrome. Crit Care Med.1999; 27: A21.
14. Lim Ch, Koh Y, Park W, Chin JY. Mechanistic scheme and effect of “extended sigh” as a recruitment maneuver in patients with acute respiratory distrés síndrome: a Preliminary study. Crit Care Med. 2001; 29: 1255-60.
15. Foti G, Cereda M, Sparacino ME, de Marchi L, Villa F, Pesenti A. Effects of periodic lung recruitment maneuvers on gas exchange and respiratory mechanics in mechanically ventilated acute respiratory distrés syndrome (ARDS) patients. Intensive Care Med 2000;26:501-7. .
16. Kacmarek RM. Strategies to optimize alveolar recruitment. Curr Opin Crit Care 2001;7:15-20. .
17. San Román JE, Giannasi SE. Efectos fisiológicos de una maniobra de reclutamiento alveolar escalonada en pacientes con SDRA en etapa precoz. Med int 2003, 27, 662- 668.
18. Villagrá A, Fernández MM, Fernández R, Blanch Li. Safety of the alveolar recruitment maneuvers in patients with acute respiratory distrés syndrome [Abstract]. Intensive Care Med. 1999; 25: S 73.
19. Jardin F, Delorme G, Hardy A. Reevaluation of hemodynamic consequences of positive pressure ventilation: Emphasis on cyclic right ventricular after loading by mechanical lung inflation. Anesthesiology 1990; 72: 966-970
20. Tusman G, Böhm SH. Efectos de la maniobra de reclutamiento alveolar y la PEEP sobre la oxigenación arterial en pacientes obesos anestesiados. Rev. Esp. Anestesiol. Reanim. 2002; 49: 177-183.
21. Villagrá A, Ochagavía A, Vatua S, Murias G. Recruitment maneuvers during lung protective ventilation in acute respiratory distrés syndrome. AJ Respir Crit Care Med. 2002; 165: 165-70.
22. Dueñas Castell C, García Del Rio C. Efectos de las maniobras de reclutamiento alveolar en el postoperatorio de cirugía cardiovascular. ARTICULO ORIGINAL. Crit Care Med. 2001 30: 230-233
23. Sjostrand UH, Lichtwarck-Aschoff M, Nielsen JB, Markstrom A, Larsson A, Svensson BA, et al. Different ventilatory approaches to keep the lung open. Intensive Care Med 1995;21: 310-8. .
24. Rothen HU, Sporre B, Engberg G, Wegenius G, Hedenstierna G. Reexpansion of atelectasis during general anaesthesia: a computed tomography study. Br J Anaesth 1993;71:788-95.
25. Gattinoni L, Pelosi P, Crotti S, Valenza F. Effects of positive end-expiratory pressure on regional distribution of tidal volume and recruitment in adult respiratory distrés syndrome. Am J Respir Crit Care Med 1995;151:1807-14.
26. Tusman M.D. How to Open the Lung? The Unsolved Question. Anesthesiology, 2000, 93. Correspondence.
27. Dreyfuss D, Saumon G. Role of tidal volume, functional residual capacity, and end-inspiratory volume in the development of pulmonary edema following mechanical ventilation. Am Rev Respir Dis 1993; 148:1194-203 .
28. Lapinsky SE, Aubin M, Mehta S, Boiteau P, Slutsky AS. Safety and efficacy of a sustained inflation for alveolar recruitment in adults with respiratory failure. Intensive Care Med 1999; 25: 1297-301.
29. Marini JJ. Recruitment maneuvers to achieve an “open lung” whether and how? Crit Care Med 2001; 29: 1647-8.
30. Grasso S, Mascia L, Del Turco M, Malacarne P, Giunta F, Brochard L, Slutsky AS, Ranieri VM. Effects of recruiting maneuvers in patients with acute respiratory distress syndrome ventilated with protective
ventilatory strategy. Anesthesiology 2002; 96: 795-802. .
31. Mead J, Takishima T, Leith D. Stress distribution in lungs: a model of pulmonary elasticity. J Appl Physiol 1970; 28:596-608
32. Rothen HU, Sporre B, Engberg G, Wegenius G, Hedenstierna G. Reexpansion of atelectasis during general anaesthesia may have a prolonged effect. Acta Anaesthesiol Scand 1995;39:118–125.
33. Rothen HU, Neumann P, Berglund JE, Valtysson J, Magnusson A, Hedenstierna G. Dynamics of re-expansion of atelectasis during general anaesthesia. Br J Anaesth 1999;82:551–556.
34. Pierson DJ. Barotrauma and bronchopleural fistula. In: Tobin MJ, ed. Principles and practice of mechanical ventilation. New York: McGraw-Hill; 1994:813-36.
35. Tusman G, Böhm S, Tempra A. Effects of Recruitment Maneuver on Atelectasis in Anesthetized Children. Anesthesiology 2003; 98:14-22.
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Pérez Calleja L, Guirola de la Parra J, Pollo Inda JD. Use of an alveolar recruitment maneuver. Mediciego [Internet]. 2004 Sep. 22 [cited 2024 Dec. 21];10(2). Available from: https://revmediciego.sld.cu/index.php/mediciego/article/view/2664
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