Pulmonary volume recruitment manoeuvre restores pulmonary compliance and resistance after apnoea in anaesthetized lambs

Abstract

These results demonstrate that significant deterioration occurs in Crs and Rrs following 2 min of apnoea in anaesthetized lambs, which is not corrected with normal ventilation but is rapidly and completely reversed with a TRIM. This supports our hypothesis that volume recruitment of alveoli is an effective manoeuvre in restoring lung function. The practice of preoxygenation is also reinforced as the lambs maintained maximal oxygen saturation if they were ventilated with 100% oxygen prior to the 2 min of apnoea.

Relato de caso: Intervenção fisioterapêutica na atelectasia

“…Outra técnica fisioterapêutica utilizada na condução deste caso foi uma adaptação da PEEP, a PEEP subaquática ou "caseira", cujo valor considerado "recrutativo" de áreas colapsadas fica acima de 10 cmH20 (PRESTO; PRESTO, 2003). A comprovação da PEEP, no que concerne a promoção da reexpansão alveolar, foi identificada em pesquisa que adicionou esse recurso após a fase inspiratória ter ocorrido a cargo de um ventilador (RUSSEL et al, 2002).…”

Pulmonary volume recruitment restores pulmonary compliance and resistance in anaesthetized young children

“…We have previously shown TRIM to be significantly faster in reversing haemoglobin oxygen desaturation in lambs caused by a period of apnoea compared with restarting ventilation with 100% oxygen (19). TRIM also increases pulmonary compliance and decreases resistance after a period of apnoea in lambs (20). Although there is no demonstrable increase in areas of atelectasis seen on CT scans over the same period of apnoea (31), these areas may be too small to see.…”

“…Informed consent was obtained from parents. The estimation of the sample size ( n =20) was based on a power of 90% to detect a 20% difference in compliance at a significance level of 0.05 using data from animal work (20).…”

“…A volume recruitment technique, called a timed reexpansion inspiratory manoeuvre (TRIM), a constant pressure of 30 cmH 2 O for 10 s has been shown to reverse haemoglobin oxygen desaturation in lambs significantly faster than restarting ventilation (mean 22.5 s compared with 42.5 s, P < 0.004 (19). In lambs TRIM also reconstitutes pulmonary compliance lost during after a 2‐min period of apnoea (20).…”