Intensive Care Medicine

, Volume 31, Issue 9, pp 1189–1194

Lung recruitment maneuver depresses central hemodynamics in patients following cardiac surgery

  • Jonas Nielsen
  • Morten Østergaard
  • Jesper Kjaergaard
  • Jens Tingleff
  • Preben G. Berthelsen
  • Eigil Nygård
  • Anders Larsson
Original

DOI: 10.1007/s00134-005-2732-z

Cite this article as:
Nielsen, J., Østergaard, M., Kjaergaard, J. et al. Intensive Care Med (2005) 31: 1189. doi:10.1007/s00134-005-2732-z

Abstract

Objective

To assess the impact of the lung recruitment maneuver on circulation following cardiac surgery.

Design and setting

Prospective randomized cross-over study at the Departments of Anesthesia and Thoracic Surgery, Copenhagen University Hospital.

Patients

Ten adult undergoing coronary artery bypass surgery.

Interventions

Patients were randomized to two durations of lung recruitment maneuvers (40 cmH2O airway pressure for 10 s and 20 s or vice versa after 5 min) administered immediately after surgery.

Measurements and results

Transesophageal echocardiography (left ventricular short axis view), pulse contour cardiac output, and arterial blood pressure were monitored continuously. Systemic and pulmonary arterial blood gases were sampled before and after each lung recruitment maneuver to calculate the intrapulmonary shunt. Left ventricular end-diastolic areas decreased significantly during both the 10-s and the 20-s lung recruitment maneuvers. Cardiac output was 5.6±0.8 l/min at baseline, decreasing by 3.0±1.1 l/min and 3.6±1.2 l/min during lung recruitment maneuvers of 10 and 20 s, respectively. Shunt decreased from 20±5% to 15±6% after the first lung recruitment maneuver and from 15±6% to 12±5% after the second.

Conclusions

Lung recruitment maneuvers markedly reduced cardiac output and left ventricular end-diastolic areas in hemodynamically stable patients following cardiac surgery.

Keywords

Lung recruitment maneuver Cardiac output Cardiac surgery Pulse contour cardiac output Transesophageal echocardiography Anesthesia 

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Jonas Nielsen
    • 1
  • Morten Østergaard
    • 1
  • Jesper Kjaergaard
    • 2
  • Jens Tingleff
    • 3
  • Preben G. Berthelsen
    • 1
  • Eigil Nygård
    • 1
  • Anders Larsson
    • 4
  1. 1.Department of Anesthesia and Intensive Care MedicineCopenhagen University Hospital GentofteHellerupDenmark
  2. 2.Department of CardiologyCopenhagen University Hospital GentofteHellerupDenmark
  3. 3.Department of Thoracic SurgeryCopenhagen University Hospital GentofteHellerupDenmark
  4. 4.Department of Anesthesia and Intensive Care Medicine, Aalborg Hospital Århus University HospitalAalborgDenmark

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