Lung Recruitment: The Role of Recruitment Maneuvers

Respir Care. 2002 Mar;47(3):308-17; discussion 317-8.

Abstract

There is increasing appreciation that lung-protective strategies are beneficial in patients with acute respiratory distress syndrome. Using low tidal volume in these patients improves survival. However, low tidal volume ventilation may promote alveolar de-recruitment. This has led some to advocate the use of "open lung" strategies that stress the use of high positive end-expiratory pressure levels and recruitment maneuvers. A recruitment maneuver is a sustained increase in airway pressure with the goal to open collapsed lung tissue. A variety of approaches have been used as recruitment maneuvers, including increasing the level of positive end-expiratory pressure, sustained inflation maneuvers, sigh breaths, spontaneous breathing, and others. There have been a number of recent reports describing improvements in arterial oxygenation with the use of recruitment maneuvers. However, the impact of recruitment maneuvers on patient-important outcomes such as survival is unknown.

Publication types

  • Review

MeSH terms

  • Anesthesia, General
  • Animals
  • High-Frequency Ventilation
  • Humans
  • Positive-Pressure Respiration
  • Pulmonary Alveoli / physiopathology
  • Pulmonary Atelectasis / physiopathology
  • Respiration, Artificial*
  • Respiratory Distress Syndrome, Adult / physiopathology
  • Respiratory Distress Syndrome, Adult / therapy
  • Respiratory Insufficiency / physiopathology*
  • Respiratory Insufficiency / therapy*
  • Tidal Volume