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Year : 2011  |  Volume : 1  |  Issue : 2  |  Page : 114-120

A comparison between two different alveolar recruitment maneuvers in patients with acute respiratory distress syndrome

Anesthesiology and ICU Department, Minoufiya Faculty of Medicine, Egypt

Correspondence Address:
Khaled M Mahmoud
3 Yaseen Abdelghaffar st., Shebin El Kom, Minoufiya
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Source of Support: Minoufi ya University, Conflict of Interest: None

DOI: 10.4103/2229-5151.84795

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Background: Alveolar recruitment is a physiological process that denotes the reopening of previously gasless lung units exposed to positive pressure ventilation. The current study was aimed to compare two recruitment maneuvers, a high continuous positive airway pressure (CPAP), and an extended sigh in patients with ARDS. Materials and Methods: Forty patients with acute respiratory distress syndrome were randomly divided into two groups, 20 patients each. Group I received a CPAP of 40 cmH 2 O for 40 seconds and group II received extended sigh (providing a sufficient recruiting pressure Χ time). In our study, we assessed the effects of both recruitment maneuvers on respiratory mechanics, gas exchange, and hemodynamics. These data were analyzed using two-way analysis of variance (ANOVA) followed by a Student--Newman--Keuls post hoc comparison test. P < 0.05 was considered statistically significant. Results: Both methods improved the compliance, increased arterial oxygenation (PaO 2 ), increased the PaO 2 /FiO 2 ratio, and reduced the pulmonary shunt fraction (Q s/Q t). However, the extended sigh improved both PaO 2 and PaO 2 /FiO 2 ratios more than continuous positive airway pressure. Also the hemodynamic parameters were better maintained during the extended sigh. Conclusion: Alveolar recruitment maneuvers are effective in management of mechanically ventilated ARDS patients. We conclude that extended sigh is more effective than continuous positive airway pressure as a recruitment maneuver.

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