Respiratory effects of recruitment maneuvers according to lung recruitability assessed by electrical impedance tomography in patients with acute respiratory distress syndrome.
Dinh Van Trung, Bui Thi Huong Giang, Dang Quoc Tuan et al.
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In 30 seconds
This randomized controlled trial assessed the effects of recruitment maneuvers (RM) followed by EIT-guided PEEP titration in 50 patients with moderate-to-severe ARDS. Patients were categorized based on lung recruitability, with those in the high-recruitability group showing significant improvements in oxygenation (PaO2/FiO2: 100.8 ± 30.3 vs. 125.4 ± 38.3 mmHg, p < 0.05) and static compliance after RM, while low-recruitability patients exhibited no significant benefits.
Key findings
- In high recruitability patients, PaO2/FiO2 improved from 100.8 ± 30.3 to 125.4 ± 38.3 mmHg after RM (p < 0.05).
- Static compliance increased significantly from 21.5 ± 5.8 to 28.0 ± 7.0 mL/cmH2O in high recruitability patients (p < 0.001).
- Driving pressure decreased from 19.1 ± 3.5 to 15.6 ± 3.2 cmH2O in high recruitability patients (p < 0.001).
- Low recruitability patients experienced no significant improvements and had numerically more cardiorespiratory adverse events.
Why it matters
Understanding lung recruitability can guide clinicians in optimizing recruitment maneuvers and PEEP settings in ARDS patients, potentially improving oxygenation and lung mechanics while minimizing adverse events.