Critical Care

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Commentary

Recruitment and retention of lung volume

Stephen E Lapinsky

Author Affiliations

Associate Director, Intensive Care Unit, Mount Sinai Hospital & Interdisciplinary Division of Critical Care, University of Toronto, Toronto, Ontario, Canada

Critical Care 2003, 7:9-10 doi:10.1186/cc1857

Published: 18 December 2002

Abstract

Both a reduction in tidal volume and alveolar recruitment may be necessary to prevent ventilator-induced lung injury in the management of patients with acute respiratory distress syndrome. The lung collapse associated with endotracheal suctioning produces hypoxaemia, but it also causes de-recruitment, potentially aggravating lung injury. A study conducted by Dyhr and colleagues demonstrates the benefit of lung recruitment manoeuvres after suctioning, which help to improve oxygenation and restore lung volume more rapidly. Although this intervention appears safe and beneficial, the precise role of lung volume recruitment manoeuvres remains to be elucidated.

Keywords:
acute respiratory distress syndrome; atelectasis; mechanical ventilation; suctioning