Effect of alveolar recruitment maneuver on pulse pressure variation: a case report

Abstract

This research aimed to evaluate the effect of the alveolar recruitment maneuver and the identification of the ideal PEEP on the Pulse Pressure Variation (PPV) in a patient with acute respiratory failure under mechanical ventilation. To verify the ideal PEEP, the Open Lung Approach (OLA) alveolar recruitment maneuver was performed, and the PPV was evaluated at each stage of the recruitment protocol. The PPV presented a lower percentage in the plateau stages below 30ml/cmH2O and in the best Static Compliance of the Respiratory System (Csr). Optimal PEEP, in addition to promoting the opening of collapsed units, minimizes the occurrence of atelectrauma and possibly the dynamic overdistension of the respiratory system, reducing pulmonary vascular resistance, cardiac work and the use of vasoactive drugs.