Lung recruitment - A guide for clinicians

Jauncey-Cooke, Jacqueline, Bogossian, Fiona E. and East, Christine E. (2009) Lung recruitment - A guide for clinicians. Australian Critical Care, 22 4: 155-162. doi:10.1016/j.aucc.2009.06.004

Author Jauncey-Cooke, Jacqueline
Bogossian, Fiona E.
East, Christine E.
Title Lung recruitment - A guide for clinicians
Journal name Australian Critical Care   Check publisher's open access policy
ISSN 1036-7314
Publication date 2009-11
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.aucc.2009.06.004
Volume 22
Issue 4
Start page 155
End page 162
Total pages 8
Editor Gavin Leslie
Place of publication United States
Publisher Elsevier Inc
Collection year 2010
Language eng
Subject C1
Abstract Recruitment manoeuvres play an important role in minimising ventilator associated lung injury (VALI) particularly when lung protective ventilation strategies are employed and as such clinicians should consider their application. This paper provides evidence-based recommendations for clinical practice with regard to alveolar recruitment. It includes recommendations for timing of recruitment, strategies of recruitment and methods of measuring the efficacy of recruitment manoeuvres and contributes to knowledge about the risks associated with recruitment manoeuvres. There are a range of methods for recruiting alveoli, most notably by manipulating positive end expiratory pressure (PEEP) and peak inspiratory pressure (PIP) with consensus as to the most effective not yet determined. A number of studies have demonstrated that improvement in oxygenation is rarely sustained following a recruitment manoeuvre and it is questionable whether improved oxygenation should be the clinician’s goal. Transient haemodynamic compromise has been noted in a number of studies with a few studies reporting persistent, harmful sequelae to recruitment manoeuvres. No studies have been located that assess the impact of recruitment manoeuvres on length of ventilation, length of stay, morbidity or mortality. Recruitment manoeuvres restore end expiratory lung volume by overcoming threshold opening pressures and are most effective when applied after circuit disconnection and airway suction. Whether this ultimately improves outcomes in adult or paediatric populations is unknown.
Keyword Mechanical ventilation
Positive and expiratory pressure
Sustained inflation
Lung protective ventilation
Q-Index Code C1
Q-Index Status Confirmed Code

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Created: Mon, 24 Aug 2009, 09:46:12 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work