TY - JOUR
T1 - Clinical review: bedside assessment of alveolar recruitment
AU - Richard, J. C
AU - Maggiore, Salvatore Maurizio
AU - Mercat, A.
PY - 2004
Y1 - 2004
N2 - Recruitment is a dynamic physiological process that refers to the reopening of previously gasless lung units. Cumulating evidence has led to a better understanding of the rules that govern both recruitment and derecruitment during mechanical ventilation of patients with acute respiratory distress syndrome. Therefore not only the positive end-expiratory pressure, but also the tidal volume, the inspired oxygen fraction, repeated tracheal suctioning as well as sedation and paralysis may affect recruitment of acute respiratory distress syndrome lungs that are particularly prone to alveolar instability. In the present article, we review the recently reported data concerning the physiological significance of the pressure-volume curve and its use to assess alveolar recruitment. We also describe alternate techniques that have been proposed to assess recruitment at the bedside. Whether recruitment should be optimized remains an ongoing controversy that warrants further clinical investigation.
AB - Recruitment is a dynamic physiological process that refers to the reopening of previously gasless lung units. Cumulating evidence has led to a better understanding of the rules that govern both recruitment and derecruitment during mechanical ventilation of patients with acute respiratory distress syndrome. Therefore not only the positive end-expiratory pressure, but also the tidal volume, the inspired oxygen fraction, repeated tracheal suctioning as well as sedation and paralysis may affect recruitment of acute respiratory distress syndrome lungs that are particularly prone to alveolar instability. In the present article, we review the recently reported data concerning the physiological significance of the pressure-volume curve and its use to assess alveolar recruitment. We also describe alternate techniques that have been proposed to assess recruitment at the bedside. Whether recruitment should be optimized remains an ongoing controversy that warrants further clinical investigation.
KW - acute lung injury
KW - acute respiratory distress syndrome
KW - alveolar recruitment
KW - mechanical ventilation
KW - pressure-volume curve
KW - volume history
KW - acute lung injury
KW - acute respiratory distress syndrome
KW - alveolar recruitment
KW - mechanical ventilation
KW - pressure-volume curve
KW - volume history
UR - http://hdl.handle.net/10807/51835
UR - http://ccforum.com/content/8/3/163
M3 - Article
SN - 1364-8535
VL - 8
SP - 163
EP - 169
JO - Critical Care
JF - Critical Care
ER -