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A comparison between two different alveolar recruitment maneuvers in patients with acute respiratory distress syndrome.
MedLine Citation:
PMID:  22229134     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Alveolar recruitment is a physiological process that denotes the reopening of previously gasless lung units exposed to positive pressure ventilation. The current study was aimed to compare two recruitment maneuvers, a high continuous positive airway pressure (CPAP), and an extended sigh in patients with ARDS.
MATERIALS AND METHODS: Forty patients with acute respiratory distress syndrome were randomly divided into two groups, 20 patients each. Group I received a CPAP of 40 cm H(2)O for 40 seconds and group II received extended sigh (providing a sufficient recruiting pressure × time). In our study, we assessed the effects of both recruitment maneuvers on respiratory mechanics, gas exchange, and hemodynamics. These data were analyzed using two-way analysis of variance (ANOVA) followed by a Student--Newman--Keuls post hoc comparison test. P < 0.05 was considered statistically significant.
RESULTS: Both methods improved the compliance, increased arterial oxygenation (PaO(2)), increased the PaO(2)/FiO(2) ratio, and reduced the pulmonary shunt fraction (Q(s)/Q(t)). However, the extended sigh improved both PaO(2) and PaO(2)/FiO(2) ratios more than continuous positive airway pressure. Also the hemodynamic parameters were better maintained during the extended sigh.
CONCLUSION: Alveolar recruitment maneuvers are effective in management of mechanically ventilated ARDS patients. We conclude that extended sigh is more effective than continuous positive airway pressure as a recruitment maneuver.
Authors:
Khaled M Mahmoud; Amany S Ammar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of critical illness and injury science     Volume:  1     ISSN:  2231-5004     ISO Abbreviation:  Int J Crit Illn Inj Sci     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2012-01-09     Completed Date:  2012-08-23     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101571136     Medline TA:  Int J Crit Illn Inj Sci     Country:  India    
Other Details:
Languages:  eng     Pagination:  114-20     Citation Subset:  -    
Affiliation:
Anesthesiology and ICU Department, Minoufiya Faculty of Medicine, Egypt.
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