Repeated Recruitment Manoeuvers during Mechanical Ventilation in ARDS Patients

Overview

Recruitment manoeuvre is considered to be an important part of current state-of-the-art ventilatory strategy in ARDS patients. We evaluated theeffect of repeated recruitment manoeuvres during mechanical ventilation of ARDS patients in a retrospective study. We enrolled 25 patients meetingARDS criteria. 12 patients were assigned to repeated recruitment manoeuvre (ROM), 13 patients were ventilated with recruitment manoeuvre only foroptimalization of ventilatory mode (control group). Pulmonary functions were assessed using the ratio of partial tension of O2 in arterialblood/inspiratory fraction of O2 –⁠ oxygenation index and PEEP level (on admission and hospital day 2, 4 and 6). Duration of mechanical ventilation,incidence of nosocomial pneumonia, barotrauma and clinical outcome (survival) represented additional followed parameters. Both groups werecomparable in age, basic underlying illness, APACHE II and SOFA score on admission. Oxygenation indexes on admission were not statisticallysignificantly different between groups (150,4 ± 40,5 vs. 141,3 ± 34,9 in ROM and control group, respectively). Oxygenation index on hospital days 4and 6 were significantly higher in ROM group (306,2 ± 79,2 and 323,8 ± 25,6) compared to control group (240 ± 83,4 and 258,3 ± 34,3). Durationof mechanical ventilation and in-hospital stay were not significantly different between groups. Repeated recruitment manoeuvres in study populationwere associated with improved oxygenation.

Key words:
ARDS –⁠ recruitment manoeuvre –⁠ oxygenation –⁠ mechanical ventilation