Cargando…
Clinical review: Bedside assessment of alveolar recruitment
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 sy...
Autores principales: | , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2004
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC468885/ https://www.ncbi.nlm.nih.gov/pubmed/15153234 http://dx.doi.org/10.1186/cc2391 |
_version_ | 1782121621969960960 |
---|---|
author | Richard, Jean-Christophe Maggiore, Salvatore M Mercat, Alain |
author_facet | Richard, Jean-Christophe Maggiore, Salvatore M Mercat, Alain |
author_sort | Richard, Jean-Christophe |
collection | PubMed |
description | 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. |
format | Text |
id | pubmed-468885 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2004 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-4688852004-07-16 Clinical review: Bedside assessment of alveolar recruitment Richard, Jean-Christophe Maggiore, Salvatore M Mercat, Alain Crit Care Review 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. BioMed Central 2004 2003-10-22 /pmc/articles/PMC468885/ /pubmed/15153234 http://dx.doi.org/10.1186/cc2391 Text en Copyright © 2004 BioMed Central Ltd |
spellingShingle | Review Richard, Jean-Christophe Maggiore, Salvatore M Mercat, Alain Clinical review: Bedside assessment of alveolar recruitment |
title | Clinical review: Bedside assessment of alveolar recruitment |
title_full | Clinical review: Bedside assessment of alveolar recruitment |
title_fullStr | Clinical review: Bedside assessment of alveolar recruitment |
title_full_unstemmed | Clinical review: Bedside assessment of alveolar recruitment |
title_short | Clinical review: Bedside assessment of alveolar recruitment |
title_sort | clinical review: bedside assessment of alveolar recruitment |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC468885/ https://www.ncbi.nlm.nih.gov/pubmed/15153234 http://dx.doi.org/10.1186/cc2391 |
work_keys_str_mv | AT richardjeanchristophe clinicalreviewbedsideassessmentofalveolarrecruitment AT maggioresalvatorem clinicalreviewbedsideassessmentofalveolarrecruitment AT mercatalain clinicalreviewbedsideassessmentofalveolarrecruitment |