Alveolar recruitment versus hyperinflation: a balancing act

@article{Dueck2006AlveolarRV,
  title={Alveolar recruitment versus hyperinflation: a balancing act},
  author={Ron Dueck},
  journal={Current Opinion in Anaesthesiology},
  year={2006},
  volume={19},
  pages={650–654}
}
  • R. Dueck
  • Published 1 December 2006
  • Medicine
  • Current Opinion in Anaesthesiology
Purpose of review To address lung recruitment according to pressure/volume curves, along with regional recruitment versus hyperinflation evidence from computed tomography and electrical impedance tomography. Recent findings Cyclical tidal volume recruitment of atelectatic lung regions causes acute lung injury, as do large breaths during pneumonectomy. Using the lower inflection point on the static pressure/volume inflation curve plus 2 cmH2O as a positive end-expiratory pressure setting limits… 
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TLDR
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TLDR
Recruitment maneuver improved PaO2/FiO2 ratio by ≥20% in 50% of patients ventilated in CPAP/PS mode.
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TLDR
This chapter focuses on controlled mechanical ventilation, under which the patient is not able to trigger a valid breath and the ventilator overtakes all the workload of respiratory muscles.
Interaction of dependent and non-dependent regions of the acutely injured lung during a stepwise recruitment manoeuvre.
TLDR
EIT imaging of regional lung mechanics reveals that overdistension in the non-dependent region precedes atelectasis reversal in the dependent region during a stepwise recruitment manoeuvre.
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TLDR
Recruitment followed by ZEEP was more deleterious in ALI than in mechanical ATEL, although ZEEP alone did not elevate PCIII expression.
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TLDR
In a lavage model of acute lung injury alveolar recruitment can be achieved with a slow lower pressure recruitment maneuver with less circulatory depression and negative lung mechanic side effects than with higher pressure recruitment maneuvers.
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TLDR
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TLDR
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TLDR
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Effects of Positive End-expiratory Pressure on Gas Exchange in Dogs with Normal and Edematous Lungs
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In dogs with pulmonary edema, PEEP's of 5 and 10 cm H2O resulted in dramatic reductions in shunt, virtual obliteration of low VA/Q regions, and market improvement in Pao2, however, at 15 and 20 cm H 2O PEP's highVA/Q and dead space ventilation with CO2 retention again developed in all but the most severely affected dogs.
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