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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...

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Detalles Bibliográficos
Autores principales: Richard, Jean-Christophe, Maggiore, Salvatore M, Mercat, Alain
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
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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.
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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
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