Intensive Care Medicine

, Volume 25, Issue 11, pp 1297–1301 | Cite as

Safety and efficacy of a sustained inflation for alveolar recruitment in adults with respiratory failure

  • S. E. Lapinsky
  • M. Aubin
  • S. Mehta
  • P. Boiteau
  • A. S. Slutsky
BRIEF REPORT

Abstract

Objective: To assess the safety and efficacy of a sustained inflation, used as a lung volume recruitment maneuver in ventilated patients with hypoxemic respiratory failure.¶Design: Prospective data collection as part of a quality assurance program following introduction of a lung volume recruitment guideline in the intensive care unit.¶Setting: Academic medical-surgical critical care unit.¶Patients: Hypoxemic patients with bilateral pulmonary infiltrates. Patients with chronic obstructive pulmonary disease, pulmonary barotrauma and hemodynamic instability were excluded.¶Interventions: A sustained inflation using a pressure of 30 to 45 cmH2O was applied for 20 s. The pressure was determined as the lesser of 45 cmH2O or the peak pressure while ventilated at a tidal volume of 12 ml/kg. Intra-arterial blood pressure and pulse oximetry were monitored continuously.¶Measurements and results: Significant improvement in oxygenation occurred in the majority of patients within 10 min. The mean oxygen saturation improved from 86.9 ± 5.5 to 94.3 ± 2.3 % (p < 0.01). No significant adverse effects were noted: hypotension and mild oxygen desaturation occurred in some patients during the 20-s inflation, reversing rapidly after inflation was terminated. No barotrauma occurred.¶Conclusions: A sustained inflation is a safe, clinically applicable method of lung volume recruitment which improves oxygenation in selected patients and may have a role in ventilatory management.

Key words Mechanical ventilation Respiratory distress syndrome, adult Lung physiopathology ¶Lung recruitment 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • S. E. Lapinsky
    • 1
  • M. Aubin
    • 1
  • S. Mehta
    • 1
  • P. Boiteau
    • 1
  • A. S. Slutsky
    • 1
  1. 1.Critical Care Unit, Department of Medicine, Mount Sinai Hospital; Critical Care Medicine Programme, and Respiratory Division, University of Toronto, Toronto, Ontario, CanadaCA

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