Central hemodynamics during lung recruitment maneuvers at hypovolemia, normovolemia and hypervolemia. A study by echocardiography and continuous pulmonary artery flow measurements in lung-injured pigs

Nielsen, Jonas B.; Nilsson, M.; Fredén, Filip; Hultman, Jan; Alström, Ulrica; Kjærgaard, Jesper; Hedenstierna, Göran; Larsson, Anders

doi:10.1007/s00134-006-0176-8

Cited by 12 publications

(19 citation statements)

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“…This finding proved that RM is safe in clinical practice, as was reported in the literature. [19,20] In summary, lung recruitment maneuver can improve oxygenation in patients with ARDS, lower EVLWI, increase lung compliance, and decrease airway pressure. In addition, lung recruitment maneuver is safe in clinical treatment.…”

Section: Discussionmentioning

confidence: 99%

Lung recruitment maneuver effects on respiratory mechanics and extravascular lung water index in patients with acute respiratory distress syndrome

Zhang¹,

Chen²,

Liu³

et al. 2011

World Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Lung recruitment maneuver effects on respiratory mechanics and extravascular lung water index in patients with acute respiratory distress syndrome

Zhang¹,

Chen²,

Liu³

et al. 2011

World Journal of Emergency Medicine

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“…62 Transient reduction in cardiac output have been noted in experimental studies. 39,[62][63][64][65] There is the potential that lung recruitment may contribute to the barotrauma associated with mechanical ventilation. An experimental study by Frank and colleagues determined the degree of alveolar and lung endothelial injury post a sustained inflation recruitment manoeuvre.…”

Section: What Harm Can Lung Recruitment Cause?mentioning

confidence: 99%

Paediatric lung recruitment: a review of the clinical evidence

Jauncey‐Cooke

East

Bogossian

2015

Paediatric Respiratory Reviews

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“…A significant decrease in MAP can be expected in hypo-and even normovolemic patients, while hypervolemia somewhat attenuates these negative effects (Nielsen et al 2006). In humans it is advocated before an ARM either to test the susceptibility of the cardiovascular system by observing arterial pressure with a short sequence of high airway pressure, or to administer fluid boluses before starting an ARM sequence when a suspicion of cardiovascular instability or hypovolemia exists (Odenstedt et al 2005).…”

Section: Introductionmentioning

confidence: 99%

The use of positive end-expiratory pressure (PEEP) and alveolar recruitment manoeuvre (ARM) in equine anaesthesia – a review

Küls¹,

Braun²,

Moens³

2016

PHK

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Summary: Impairment of gas exchange and arterial oxygenation during general anaesthesia and recumbency of the horse are a common and well-known problem. Often these alterations are poorly responsive to intermittent positive pressure ventilation (IPPV) and increasing levels of supplemental oxygen. Over the last decades the understanding of the underlying pathophysiology developed more and more, recognizing that a decrease in functional residual capacity (FRC), lung collapse and atelectasis, and ultimately ventilation/perfusion mismatch lead to poor oxygenation. Accordingly, new ventilation strategies arose over the course of time including alveolar recruitment manoeuvres (ARMs) and positive end expiratory pressure (PEEP). In 1992 Burkhard Lachmann presented his idea of an 'open lung' concept using high peak inspiratory pressures to reopen atelectatic lung regions followed by sufficiently high PEEP to keep the recruited lung areas open. In equine anaesthesia, early attempts with continuous positive pressure in spontaneously breathing horses yielded rather disappointing results. In combination with IPPV the use of PEEP resulted in unreliable improvements in the partial pressure of oxygen in arterial blood (PaO 2 ). Once the pre-treatment with an ARM prior to PEEP was introduced, improvement in PaO 2 could be seen to be more reliable. Despite these promising results, there is a risk of adverse effects with the use of PEEP and ARM in horses due to the high pressures that are necessary to achieve an effect. A reduction in cardiac output proportional to the increase in intrathoracic pressure has been observed and may compromise peripheral blood flow as well as gastrointestinal perfusion once a certain pressure threshold is reached. Similar, an increase in right to left shunt due to forcing blood into already collapsed lung areas can compromise the desired effect. Finally, early signs of ventilator induced lung injury have been detected in horses and it remains to be seen how future ventilation strategies will succeed in finding the optimal balance for each individual horse. This review presents the development and use of ARMs and PEEP in horses and its potential effect and side effects.

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Central hemodynamics during lung recruitment maneuvers at hypovolemia, normovolemia and hypervolemia. A study by echocardiography and continuous pulmonary artery flow measurements in lung-injured pigs

Cited by 12 publications

References 0 publications

Lung recruitment maneuver effects on respiratory mechanics and extravascular lung water index in patients with acute respiratory distress syndrome

Lung recruitment maneuver effects on respiratory mechanics and extravascular lung water index in patients with acute respiratory distress syndrome

Paediatric lung recruitment: a review of the clinical evidence

The use of positive end-expiratory pressure (PEEP) and alveolar recruitment manoeuvre (ARM) in equine anaesthesia – a review

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