Recruitment maneuver after apnea test or continuous positive airway pressure apnea test?
Department of Anesthesiology and Intensive Care, Teaching military hospital Sainte Anne, Boulevard Sainte Anne; BP 20545; 83041 Cedex 09 Toulon, France
Critical Care 2012, 16:445 doi:10.1186/cc11453Published: 31 August 2012
First paragraph (this article has no abstract)
We read with interest the study by Marie Paries and collaborators . Many potential lung transplants are lost because of hypoxemia after apnea test. The authors evaluated the positive effect of a single recruitment maneuver (RM) after the apnea test with encouraging effect. In light of the study from Mascia and collaborators , we think that the RM will not be necessary if the apnea test is performed with continuous positive airway pressure (CPAP; with positive pressure applied at the level of the positive end expiratory pressure used for ventilation). Using this method for the apnea test, Mascia and collaborators obtained a better PaO2/FiO2 ratio (the ratio of arterial oxygen tension to fractional inspired oxygen) after the CPAP apnea maneuver compared to the classical apnea maneuver but without the hemodynamic risk.