Lung recruitment in ARDS patients

Lung recruitment is used to improve oxygenation and decrease the risk of ventilator induced lung injuries. Assessing the potential of recruitability is a pre-requisite for a rational recruitment strategy and setting of PEEP. Using a low flow pressure-volume loop is helpful to assess the potential of recruitability at the bedside. For patients with a high potential of recruitability, recruitment maneuvers are efficient with an appropriate setting of PEEP to maintain the lung recruited. Recruitment maneuvers use pressures from 40 to 60 cmH2O for a short period of time, either with the sustained inflation or the staircase method. PEEP setting after the maneuver is important; a decreasing PEEP trial is a useful practical method.

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Sustained inflation: The lung recruitment maneuvers for neonates

Paediatric Respiratory Reviews ◽

10.1016/j.prrv.2019.09.010 ◽

2020 ◽

Vol 36 ◽

pp. 142-150

Author(s):

Ke-Yun Chao ◽

Yu-Wen Lin ◽

Chen-En Chiang ◽

Chi-Wei Tseng ◽

Shu-Chi Mu

Keyword(s):

Lung Recruitment ◽

Recruitment Maneuvers ◽

Sustained Inflation

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The effect of lung recruitment maneuvers on post-operative pulmonary complications for patients undergoing general anesthesia: A meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0217405 ◽

2019 ◽

Vol 14 (5) ◽

pp. e0217405 ◽

Cited By ~ 4

Author(s):

Yu Cui ◽

Rong Cao ◽

Gen Li ◽

Tianqing Gong ◽

Yingyu Ou ◽

...

Keyword(s):

General Anesthesia ◽

Meta Analysis ◽

Pulmonary Complications ◽

Lung Recruitment ◽

Recruitment Maneuvers

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Regional hydrology controls stream microbial biofilms: evidence from a glacial catchment

Biogeosciences Discussions ◽

10.5194/bgd-1-497-2004 ◽

2004 ◽

Vol 1 (1) ◽

pp. 497-531 ◽

Cited By ~ 1

Author(s):

T. J. Battin ◽

A. Wille ◽

R. Psenner ◽

A. Richter

Keyword(s):

Landscape Heterogeneity ◽

Low Flow ◽

Detection Rates ◽

Stream Communities ◽

Stream Discharge ◽

Carbon Production ◽

Microbial Biofilms ◽

Short Period ◽

Alpine Stream

Abstract. Glaciers are highly responsive to global warming and important agents of landscape heterogeneity. While it is well established that glacial ablation and snowmelt regulate stream discharge, linkage among streams and streamwater hydrogeochemistry, the controls of these factors on stream microbial biofilms remain insufficiently understood. We investigated glacial (metakryal, hypokryal), groundwater-fed (krenal) and snow-fed (rhithral) streams – all of them representative for alpine stream networks – and present evidence that these hydrologic and hydrogeochemical factors differentially affect sediment microbial biofilms. Average microbial biomass and bacterial carbon production were low in the glacial streams, whereas bacterial cell size, biomass, and carbon production were higher in the tributaries, most notably in the krenal stream. Whole-cell in situ fluorescence hybridization revealed reduced detection rates of the Eubacteria and higher abundance of α-Proteobacteria in the glacial stream, a pattern that most probably reflects the trophic status of this ecosystem. Our data suggest low flow during the onset of snowmelt and autumn as a short period (hot moment) of favorable environmental conditions with pulsed inputs of allochthonous nitrate and dissolved organic carbon, and with disproportional high microbial growth. Krenal and rhithral streams with more constant and favorable environments serve as possible sources of microbes and organic matter to the main glacial channel during periods (e.g. snowmelt) of elevated hydrologic linkage among streams. Ice and snow dynamics have a crucial impact on microbial biofilms, and we thus need better understanding of the microbial ecology and enhanced consideration of critical hydrological episodes in future models predicting alpine stream communities.

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The Combination of Tocilizumab and Methylprednisolone Along With Initial Lung Recruitment Strategy in Coronavirus Disease 2019 Patients Requiring Mechanical Ventilation: A Series of 21 Consecutive Cases

Critical Care Explorations ◽

10.1097/cce.0000000000000145 ◽

2020 ◽

Vol 2 (6) ◽

pp. e0145

Author(s):

Munir E. Hazbun ◽

Andrew C. Faust ◽

Anthony L. Ortegon ◽

Lyndsay A. Sheperd ◽

Gary L. Weinstein ◽

...

Keyword(s):

Mechanical Ventilation ◽

Lung Recruitment ◽

Recruitment Strategy

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Comparison of cuffed, uncuffed tracheal tubes and laryngeal mask airways in low flow pressure controlled ventilation in children

Pediatric Anesthesia ◽

10.1111/j.1460-9592.2005.01709.x ◽

2006 ◽

Vol 16 (2) ◽

pp. 140-143 ◽

Cited By ~ 14

Author(s):

THOMAS ENGELHARDT ◽

GRAHAM JOHNSTON ◽

MANISHA M. KUMAR

Keyword(s):

Laryngeal Mask ◽

Low Flow ◽

Controlled Ventilation ◽

Pressure Controlled Ventilation ◽

Flow Pressure ◽

Pressure Controlled

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Hemodynamic effects of lung recruitment maneuvers in acute respiratory distress syndrome

BMC Pulmonary Medicine ◽

10.1186/s12890-017-0369-7 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 11

Author(s):

Anup Das ◽

Mainul Haque ◽

Marc Chikhani ◽

Oana Cole ◽

Wenfei Wang ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Lung Recruitment ◽

Hemodynamic Effects ◽

Recruitment Maneuvers

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Chest ultrasound for guiding lung recruitment maneuvers

Medicina Intensiva (English Edition) ◽

10.1016/j.medine.2018.07.005 ◽

2018 ◽

Vol 42 (8) ◽

pp. e20

Author(s):

B. del Rey Hurtado de Mendoza ◽

J. Sanchez-de-Toledo ◽

J. Rodríguez-Fanjul

Keyword(s):

Lung Recruitment ◽

Chest Ultrasound ◽

Recruitment Maneuvers

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Lung recruitment maneuvers in acute respiratory distress syndrome and facilitating resolution

Critical Care Medicine ◽

10.1097/01.ccm.0000057902.29449.29 ◽

2003 ◽

Vol 31 (Supplement) ◽

pp. S265-S271 ◽

Cited By ~ 38

Author(s):

Carmen Sílvia Valente Barbas

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Lung Recruitment ◽

Recruitment Maneuvers

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Intrapulmonary Percussive Ventilation as a Lung Recruitment Strategy in Brain-Dead Organ Donors

Progress in Transplantation ◽

10.1177/1526924816679836 ◽

2016 ◽

Vol 27 (1) ◽

pp. 84-89 ◽

Cited By ~ 1

Author(s):

Geralyn Lerg ◽

Linda Shanta

Keyword(s):

Data Extraction ◽

Chest Physiotherapy ◽

Lung Recruitment ◽

Recruitment Strategy ◽

Organ Donors ◽

Safe Alternative ◽

Data Synthesis ◽

Search Terms ◽

Study Selection ◽

Donor Population

Objective: To determine the strength of the evidence evaluating the effectiveness of intrapulmonary percussive ventilation (IPV) as a safe alternative or adjunctive therapy to traditional chest physiotherapy (CPT) among potential organ donors. Data Sources: Literature search conducted from February 2015 to November 2015 using PubMed, Cumulative Index of Nursing and Allied Health Literature, Scopus, and bibliographies of pertinent articles. Search Terms: Intrapulmonary percussive ventilation, chest physiotherapy, chest wall oscillation, organ donors, and ventilation. Study Selection: Articles in English from 1994 to present directly compared IPV to CPT or conventional (no) therapy. Data Extraction: Association of Critical-Care Nurses Levels of Evidence was used to determine the strength of evidence. Level B and level C articles were reviewed. Data Synthesis: No studies were found using IPV in the donor population. Results from studies using IPV in other populations indicated IPV had no adverse effects, improved sputum clearance and oxygenation, and reduced atelectasis and pneumonia in patients with artificial airways. Conclusion: Intrapulmonary percussive ventilation may be a safe and effective alternative or adjunctive to CPT therapy and improve the number of lungs available for transplantation. Clinical research is essential to determine the effectiveness of this therapy for lung recruitment in the donor population.

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