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Intensive Care Medicine
Published in: Intensive Care Medicine 9/2005

01-09-2005 | Original

Lung recruitment maneuver depresses central hemodynamics in patients following cardiac surgery

Authors: Jonas Nielsen, Morten Østergaard, Jesper Kjaergaard, Jens Tingleff, Preben G. Berthelsen, Eigil Nygård, Anders Larsson

Published in: Intensive Care Medicine | Issue 9/2005

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Abstract

Objective

To assess the impact of the lung recruitment maneuver on circulation following cardiac surgery.

Design and setting

Prospective randomized cross-over study at the Departments of Anesthesia and Thoracic Surgery, Copenhagen University Hospital.

Patients

Ten adult undergoing coronary artery bypass surgery.

Interventions

Patients were randomized to two durations of lung recruitment maneuvers (40 cmH2O airway pressure for 10 s and 20 s or vice versa after 5 min) administered immediately after surgery.

Measurements and results

Transesophageal echocardiography (left ventricular short axis view), pulse contour cardiac output, and arterial blood pressure were monitored continuously. Systemic and pulmonary arterial blood gases were sampled before and after each lung recruitment maneuver to calculate the intrapulmonary shunt. Left ventricular end-diastolic areas decreased significantly during both the 10-s and the 20-s lung recruitment maneuvers. Cardiac output was 5.6±0.8 l/min at baseline, decreasing by 3.0±1.1 l/min and 3.6±1.2 l/min during lung recruitment maneuvers of 10 and 20 s, respectively. Shunt decreased from 20±5% to 15±6% after the first lung recruitment maneuver and from 15±6% to 12±5% after the second.

Conclusions

Lung recruitment maneuvers markedly reduced cardiac output and left ventricular end-diastolic areas in hemodynamically stable patients following cardiac surgery.
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Metadata
Title
Lung recruitment maneuver depresses central hemodynamics in patients following cardiac surgery
Authors
Jonas Nielsen
Morten Østergaard
Jesper Kjaergaard
Jens Tingleff
Preben G. Berthelsen
Eigil Nygård
Anders Larsson
Publication date
01-09-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 9/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2732-z

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