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Open Access 01-12-2011 | Review

Efficacy and safety of recruitment maneuvers in acute respiratory distress syndrome

Authors: Claude Guerin, Sophie Debord, Véronique Leray, Bertrand Delannoy, Frédérique Bayle, Gael Bourdin, Jean-Christophe Richard

Published in: Annals of Intensive Care | Issue 1/2011

Abstract

Recruitment maneuvers (RM) consist of a ventilatory strategy that increases the transpulmonary pressure transiently to reopen the recruitable lung units in acute respiratory distress syndrome (ARDS). The rationales to use RM in ARDS are that there is a massive loss of aerated lung and that once the end-inspiratory pressure surpasses the regional critical opening pressure of the lung units, those units are likely to reopen. There are different methods to perform RM when using the conventional ICU ventilator. The three RM methods that are mostly used and investigated are sighs, sustained inflation, and extended sigh. There is no standardization of any of the above RM. Meta-analysis recommended not to use RM in routine in stable ARDS patients but to run them in case of life-threatening hypoxemia. There are some concerns regarding the safety of RM in terms of hemodynamics preservation and lung injury as well. The rapid rising in pressure can be a factor that explains the potential harmful effects of the RM. In this review, we describe the balance between the beneficial effects and the harmful consequences of RM. Recent animal studies are discussed.

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Title: Efficacy and safety of recruitment maneuvers in acute respiratory distress syndrome
Authors: Claude Guerin
Sophie Debord
Véronique Leray
Bertrand Delannoy
Frédérique Bayle
Gael Bourdin
Jean-Christophe Richard
Publication date: 01-12-2011
Publisher: Springer Paris
Published in: Annals of Intensive Care / Issue 1/2011
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/2110-5820-1-9

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Efficacy and safety of recruitment maneuvers in acute respiratory distress syndrome

Abstract

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