Journal
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
Volume 167, Issue 4, Pages 521-527Publisher
AMER THORACIC SOC
DOI: 10.1164/rccm.200203-198OC
Keywords
acute lung injury; acute respiratory distress syndrome; mechanical ventilation; recruitment; end-expiratory lung volume
Categories
Ask authors/readers for more resources
Interventions aimed at recruiting the lung of patients with acute respiratory distress syndrome (ARDS) are not uniformly effective. Because the prone position increases homogeneity of inflation of the lung, we reasoned that it might enhance its potential for recruitment. We ventilated 10 patients with early ARDS (Pa-O2/Fl(O2), 121 +/- 46 mm Hg; positive end-expiratory pressure, 14 +/- 3 cm H2O) in supine and prone, with and without the addition of three consecutive sighs per minute to recruit the lung. Inspired oxygen fraction, positive end-expiratory pressure, and minute ventilation were kept constant. Sighs increased Pa-O2 in both supine and prone (p < 0.01). The highest values of Pa-O2 (192 +/- 41 mm Hg) and end-expiratory lung volume (1,840 +/- 790 ml) occurred with the addition of sighs in prone and remained significantly elevated I hour after discontinuation of the sighs. The increase in Pa-O2 associated with the sighs, both in supine and prone, correlated linearly with the respective increase of end-expiratory lung volume (r = 0.82, p < 0.001). We conclude that adding a recruitment maneuver such as cyclical sighs during ventilation in the prone position may provide optimal lung recruitment in the early stage of ARDS.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available