Thursday 2:20 PM - 3:20 PM
Recruitment maneuvers: When and how much
Recruitment maneuvers have been shown to improve oxygenation and alveolar gas volumes in patients with predominately alveolar collapse secondary to surfactant deactivation or lung compression due to an elevated pleural pressure. In fact, in these patients, as much as 50% of the lung may be recruitable. These improvements are short lived after the RM unless the applied PEEP is increased sufficiently to maintain the alveolar patency. In patients with pneumonia or other “primary” ARDS, there may be only 5% to 10% of recruitable lung since much of the affected lung is consolidated and not atelectactic and they demonstrate a markedly reduced response to a RM. It has also been noted that patients receiving high levels of PEEP are less responsive – likely because they have fewer atelectactic lung units.
Presented by: Ray Ritz, BA, RRT, FAARC