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Intensive Care Medicine
Published in: Intensive Care Medicine 10/2019

01-10-2019 | Acute Respiratory Distress-Syndrome | What's New in Intensive Care

Alveolar recruitment in acute respiratory distress syndrome: should we open the lung (no matter what) or may accept (part of) the lung closed?

Authors: Lorenzo Del Sorbo, Tommaso Tonetti, V. Marco Ranieri

Published in: Intensive Care Medicine | Issue 10/2019

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Excerpt

The conceptual model of acute respiratory distress syndrome (ARDS) includes: (a) lung inflammation; (b) severe hypoxemia; (c) edema, hyaline membranes, and alveolar hemorrhage. Common denominator is the loss of aerated lung tissue due to alveolar collapse. To open collapsed alveoli has been, therefore, proposed to restore gas exchange [1] with interventions such as positive end-expiratory pressure (PEEP), recruitment maneuvers, and prone position [2]. Moreover, loss of lung volume may contribute to ventilator-induced lung injury (VILI) [2]. We will review the physiology of alveolar recruitment and address the implications of the “full recruitment” vs “partial recruitment” approaches (Fig. 1). …
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Metadata
Title
Alveolar recruitment in acute respiratory distress syndrome: should we open the lung (no matter what) or may accept (part of) the lung closed?
Authors
Lorenzo Del Sorbo
Tommaso Tonetti
V. Marco Ranieri
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 10/2019
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-019-05734-7

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