Assessment of the efficacy of lung recruitment in improving ventilation of patients with acute respiratory distress syndrome

Abstract

Introduction Lung recruitment maneuvers (LRMs) improve oxygenation, specifically when combined with higher positive end-expiratory pressure; additionally, it might decrease the need for rescue therapy. Patients and methods A cross-sectional study had been designed, and 27 patients from respiratory care unit had been selected after they had been diagnosed with acute respiratory distress syndrome. Lung recruitment had been tried for all patients after switching ventilator to continuous positive airway pressure mode with positive end-expiratory pressure of 30 cm H2O over 30 s. SpO2, PO2, and PO2/FiO2 were monitored at baseline, immediately, and 4 h after termination of LRM. Results Patients after termination of LRM had been classified into two subgroups according to their response as improvement of PO2/FiO2 of greater than or equal to 200. Regarding this classification, 59.3% of the patients had been improved. Mean increase of PO2/FiO2 was 43.4% compared with baseline. SpO2, PO2, and PO2/FiO2 were compared among every subgroup along their course of monitoring; only responders had significant improvement after 4 h of LRM compared with baseline regarding different ventilator parameters. No significant difference between patients with different primary diagnoses was revealed regarding PO2/FiO2 at 4 h. Conclusion Lung recruitment had been successfully efficient among more than half of our studied patients. Different primary diagnoses were not predictive of improvement. Minimal adverse events had been presented among our patients after termination of lung recruitment.

Keywords

• acute respiratory distress syndrome
• lung recruitment maneuvers
• positive end espiratory pressure (PEEP)