Prevention and reversal of lung collapse during the intra-operative period

Tusman, Gerardo; Böhm, Stephan H.

doi:10.1016/j.bpa.2010.02.006

Cited by 68 publications

(87 citation statements)

References 76 publications

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“…1,2 The use of recruitment maneuvers has been proposed as a useful technique to reverse atelectasis during general anesthesia. [3][4][5][6] Nevertheless, there is no standard, universally accepted method of performing recruitment maneuvers.…”

Section: Introductionmentioning

confidence: 99%

Neonatal Pneumothorax Pressures Surpass Higher Threshold in Lung Recruitment Maneuvers: An In Vivo Interventional Study

et al. 2015

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BACKGROUND: Causing pneumothorax is one of the main concerns of lung recruitment maneuvers in pediatric patients, especially newborns. Therefore, these maneuvers are not performed routinely during anesthesia. Our objective was to determine the pressures that cause pneumothorax in healthy newborns by a prospective experimental study of 10 newborn piglets (<48 h old) with healthy lungs under general anesthesia. METHODS: The primary outcome was peak inspiratory pressure (PIP) causing pneumothorax. Animals under anesthesia and bilateral chest tube catheterization were randomly allocated to 2 groups: one with PEEP and fixed inspiratory driving pressure of 15 cm H 2 O (PEEP group) and the second one with PEEP ‫؍‬ 0 cm H 2 O and non-fixed inspiratory driving pressure (zero PEEP group). In both groups, the ventilation mode was pressurecontrolled, and PIP was raised at 2-min intervals, with steps

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Section: Introductionmentioning

confidence: 99%

Neonatal Pneumothorax Pressures Surpass Higher Threshold in Lung Recruitment Maneuvers: An In Vivo Interventional Study

et al. 2015

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“…Already in 1993, Hedenstierna's group in Sweden had described the patho-physiology around lung collapse and the physiological basis of sustained inflations-then called vital capacity maneuvers [11]. Shortly thereafter, our group demonstrated the beneficial clinical effect of a cycling RM on anesthesia-induced atelectasis [12,13]. RM has been demonstrated to be safe in a wide variety of species, patients, and surgical procedures, including thoracic ones performed under OLV [13, 57 •• ].…”

Section: Recruitment Maneuvers and The Open Lung Conceptmentioning

confidence: 99%

“…In critically ill patients, in whom hemodynamic side effects of the RM are expected, such a maneuver can be applied during OLV, because one report demonstrated that a RM on the ventilated lung alone was hemodynamically well tolerated [68]. However, in general, the hemodynamic tolerance is related to a patient's preload status and is rarely a problem in normovolemic patients [9,13,71].…”

Section: Recruitment Maneuvers and The Open Lung Conceptmentioning

confidence: 99%

“…It must be emphasized that, in most cases, one single maneuver is enough to expand the lungs and to keep the lungs ''open'' during the entire anesthesia time provided sufficient PEEP is used [9,13]. A second RM (or even more RMs) becomes necessary whenever the operated lung must be re-expanded, which is usually the case only once at the end of surgery.…”

Section: Recruitment Maneuvers and The Open Lung Conceptmentioning

confidence: 99%

“…RMs are ventilatory strategies aimed at restoring a normal functional residual capacity even during adverse circumstances such as thoracic anesthesia [11][12][13]. RM re-aerate atelectasis and areas of airway closure thereby increasing the alveolar surface for gas exchange and decreasing the mechanical stresses which are the origin of VILI.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Alveolar Recruitment Maneuvers for One-Lung Ventilation During Thoracic Anesthesia

Tusman

Böhm

Suárez-Sipmann

2014

Curr Anesthesiol Rep

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Especially during thoracic surgery, anesthesiologists have to cope with both the drastic alteration of normal pulmonary physiology and the mechanical stress on the lung tissue induced by ventilation. These problems result from the total collapse of the lung being operated on and the partial collapse of the ventilated other lung. In addition, technical factors inherent to thoracic surgery and the patient's condition potentiate such adverse effects. Traditional ventilatory settings described for thoracic surgery have not led to a decrease in the incidence of hypoxemia or perioperative atelectasis. However, lung recruitment maneuvers and ventilatory strategies are aimed at resolving lung collapse in mechanically ventilated patients, improving lung function, and decreasing the rate of post-operative pulmonary complications directly related to lung collapse. This article summarizes recent evidence for the role that lung recruitment maneuvers play during one-lung ventilation anesthesia.

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Pulmonary-Respiratory Medicine

2001

JAMA

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Prevention and reversal of lung collapse during the intra-operative period

Cited by 68 publications

References 76 publications

Neonatal Pneumothorax Pressures Surpass Higher Threshold in Lung Recruitment Maneuvers: An In Vivo Interventional Study

Neonatal Pneumothorax Pressures Surpass Higher Threshold in Lung Recruitment Maneuvers: An In Vivo Interventional Study

Alveolar Recruitment Maneuvers for One-Lung Ventilation During Thoracic Anesthesia

Pulmonary-Respiratory Medicine

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