Critical Care

official impact factor 4.60

Commentary

How best to recruit the injured lung?

John J Marini

Author Affiliations

Pulmonary and Critical Care Medicine, Regions Hospital, University of Minnesota, Minneapolis/St Paul, MN 55101, USA

Critical Care 2008, 12:159 doi:10.1186/cc6910

Published: 20 June 2008

Abstract

Sustained re-opening of collapsed lung tissue (recruitment) requires the application of airway pressures that exceed those of the tidal cycle. The post-maneuver PEEP as well as the duration of high pressure application are also key factors in its success, with their accompanying potential for hemodynamic compromise. Although a wide variety of recruiting maneuvers have been described, the technique that strikes the best balance between efficacy and risk may well vary among patients with differing right heart loading status and lung properties.