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01.12.2005 | Experimental

Slow moderate pressure recruitment maneuver minimizes negative circulatory and lung mechanic side effects: evaluation of recruitment maneuvers using electric impedance tomography

verfasst von: Helena Odenstedt, Sophie Lindgren, Cecilia Olegård, Karin Erlandsson, Sven Lethvall, Anders Åneman, Ola Stenqvist, Stefan Lundin

Erschienen in: Intensive Care Medicine | Ausgabe 12/2005

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Abstract

Objective

To evaluate the efficacy of different lung recruitment maneuvers using electric impedance tomography.

Design and setting

Experimental study in animal model of acute lung injury in an animal research laboratory.

Subjects

Fourteen pigs with saline lavage induced lung injury.

Interventions

Lung volume, regional ventilation distribution, gas exchange, and hemodynamics were monitored during three different recruitment procedures: (a) vital capacity maneuver to an inspiratory pressure of 40 cmH₂O (ViCM), (b) pressure-controlled recruitment maneuver with peak pressure 40 and PEEP 20 cmH₂O, both maneuvers repeated three times for 30 s (PCRM), and (c) a slow recruitment with PEEP elevation to 15 cmH₂O with end inspiratory pauses for 7 s twice per minute over 15 min (SLRM).

Measurements and results

Improvement in lung volume, compliance, and gas exchange were similar in all three procedures 15 min after recruitment. Ventilation in dorsal regions of the lungs increased by 60% as a result of increased regional compliance. During PCRM compliance decreased by 50% in the ventral region. Cardiac output decreased by 63±4% during ViCM, 44±2% during PCRM, and 21±3% during SLRM.

Conclusions

In a lavage model of acute lung injury alveolar recruitment can be achieved with a slow lower pressure recruitment maneuver with less circulatory depression and negative lung mechanic side effects than with higher pressure recruitment maneuvers. With electric impedance tomography it was possible to monitor lung volume changes continuously.

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Titel: Slow moderate pressure recruitment maneuver minimizes negative circulatory and lung mechanic side effects: evaluation of recruitment maneuvers using electric impedance tomography
verfasst von: Helena Odenstedt
Sophie Lindgren
Cecilia Olegård
Karin Erlandsson
Sven Lethvall
Anders Åneman
Ola Stenqvist
Stefan Lundin
Publikationsdatum: 01.12.2005
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 12/2005
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-005-2799-6

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Slow moderate pressure recruitment maneuver minimizes negative circulatory and lung mechanic side effects: evaluation of recruitment maneuvers using electric impedance tomography

Abstract

Objective

Design and setting

Subjects

Interventions

Measurements and results

Conclusions

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Objective

Design and setting

Subjects

Interventions

Measurements and results

Conclusions

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