Effects of Recruitment Manoeuvres on Haemodynamics, Oxygen Exchange and Oxygen Delivery in Patients with Acute Lung Injury and Acute Respiratory Distress Syndrome

• Published in: Critical care and resuscitation 2010-09, Vol.12 (3), p.143-148
• Main Authors: Kanoore Edul, Vanina S, Maskin, Luis P, Dubin, Arnaldo
• Format: Article
• Language: English
• Subjects: Acute Lung Injury; Artificial respiration; Critical care medicine; Hemodynamics; Humans; Lungs; Outcome assessment (Medical care); Oxygen - blood; Oxygen consumption (Physiology); Positive-Pressure Respiration; Prospective Studies; Respiratory Distress Syndrome, Adult; Wounds and injuries
• ISSN: 1441-2772
• DOI: 10.1016/S1441-2772(23)01496-5

Objective: To evaluate the impact of a recruitment manoeuvre (RM) on haemodynamics, gas exchange, and oxygen transport in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) under mechanical ventilation. Design, setting and participants: Prospective interventional study in the intensive care unit of a teaching hospital in Buenos Aires, Argentina. The study was carried out between June 2002 and March 2003. Eleven consecutive patients with ALI and ARDS who required an RM were included. Haemodynamic measurements and blood samples were taken before and during the RM, and at 2 and 30 minutes after the RM. Intervention: After baseline measurements, positive endexpiratory pressure (PEEP) was set at 40cmH2O for 45 seconds. Main outcome measures: Systemic haemodynamics, oxygen exchange and oxygen delivery. Results: Mean PEEP before the RM was 14 (SD, 3) cmH2O, and was maintained after the RM. The RM did not modify the arterial partial pressure of oxygen (PaO2) but did induce small but significant changes in the mean arterial partial pressure of carbon dioxide (PaCO2) and arterial minus end-tidal PCO2 gradient (Pa-ETCO2) at 2 minutes and 30 minutes after the RM (P