Clinical review: bedside assessment of alveolar recruitment

Salvatore Maurizio Maggiore, J. C Richard, A. Mercat

Risultato della ricerca: Contributo in rivistaArticolo in rivista

36 Citazioni (Scopus)

Abstract

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.
Lingua originaleEnglish
pagine (da-a)163-169
Numero di pagine7
RivistaCritical Care
Volume8
Stato di pubblicazionePubblicato - 2004
Pubblicato esternamenteYes

Keywords

  • acute lung injury
  • acute respiratory distress syndrome
  • alveolar recruitment
  • mechanical ventilation
  • pressure-volume curve
  • volume history

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