Lung “recruitment” or lung overinflation maneuvers?

Excerpt

Using a transgastric echocardiography study in patients undergoing coronary artery bypass surgery, Nielsen et al. in a recent issue of Intensive Care Medicine demonstrated that a lung “recruitment” maneuver produced an acute right ventricular overload [1]. The hallmark of this overload was a leftward septal shift reducing the left ventricular size [2]. From a hemodynamic point of view, whereas a true recruitment should reduce pulmonary vascular resistance, lung overinflation should increase it [3]. Thus, the “recruitment” maneuvers performed by Nielsen et al. likely did not produce any substantial “recruitment” in their patients, but an acute overinflation [1]. Recorded in patients with healthy lungs containing few atelectatic areas, Nielsen’s results are to be expected. …