Objective To compare the effectiveness of the alveolar recruitment maneuver and the breath
stacking technique with respect to lung mechanics and gas exchange in patients
with acute lung injury. Methods Thirty patients were distributed into two groups: Group 1 - breath stacking; and
Group 2 - alveolar recruitment maneuver. After undergoing conventional physical
therapy, all patients received both treatments with an interval of 1 day between
them. In the first group, the breath stacking technique was used initially, and
subsequently, the alveolar recruitment maneuver was applied. Group 2 patients were
initially subjected to alveolar recruitment, followed by the breath stacking
technique. Measurements of lung compliance and airway resistance were evaluated
before and after the use of both techniques. Gas analyses were collected before
and after the techniques were used to evaluate oxygenation and gas exchange. Results Both groups had a significant increase in static compliance after breath stacking
(p=0.021) and alveolar recruitment (p=0.03), but with no significant differences
between the groups (p=0.95). The dynamic compliance did not increase for the
breath stacking (p=0.22) and alveolar recruitment (p=0.074) groups, with no
significant difference between the groups (p=0.11). The airway resistance did not
decrease for either groups, i.e., breath stacking (p=0.91) and alveolar
recruitment (p=0.82), with no significant difference between the groups (p=0.39).
The partial pressure of oxygen increased significantly after breath stacking
(p=0.013) and alveolar recruitment (p=0.04), but there was no significant
difference between the groups (p=0.073). The alveolar-arterial O2
difference decreased for both groups after the breath stacking (p=0.025) and
alveolar recruitment (p=0.03) interventions, and there was no significant
difference between the groups (p=0.81). Conclusion Our data suggest that the breath stacking and alveolar recruitment techniques are
effective in improving the lung mechanics and gas exchange in patients with acute
lung injury.