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2025-05-06T14:36:46
RDF description of Lung recruitment in acute respiratory distress syndrome: what is the best strategy [review]? - http://repository.healthpartners.com/individual/document-rn7041
10.1097/MCC.0000000000000054
Critical Care
document-rn7041
review
Lung recruitment in acute respiratory distress syndrome: what is the best strategy [review]?
2022-02-21T22:48:57.408-06:00
Injuries
Respiratory Tract Diseases
Lung
Current Opinion in Critical Care
<p>PURPOSE OF REVIEW: Supporting patients with acute respiratory distress syndrome (ARDS) using a low tidal volume strategy is a standard practice in the ICU. Recruitment maneuvers can be used to augment other methods, like positive end-expiratory pressure and positioning, to improve aerated lung volume. Clinical practice varies widely, and optimal method and patient selection for recruitment maneuvers have not been determined. RECENT FINDINGS: Recent developments include experimental and clinical evidence that a stepwise extended recruitment maneuver may match the improvement in aerated lung volume seen with sustained inflation traditionally used, with less adverse effects. Positioning and other chest wall modifications may be useful adjuncts to recruitment maneuvers. In addition, evidence from clinical studies in the operating room suggests that recruitment maneuvers, as a component of an open lung strategy, may be helpful for mechanically ventilated patients with normal lungs. SUMMARY: As a component of ventilation strategy for patients with ARDS, the use of recruitment maneuvers, especially a stepwise maneuver, in addition to adequate positive end-expiratory pressure and appropriate positioning, is suggested by currently available data. Until their effect on clinical outcomes is further defined, the use of recruitment maneuvers in ARDS and other settings will continue to be guided by individual clinician experience and patient factors.<p>
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