Article Review: Lung Recruitability in Early

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[. . .] , 2012). Surprisingly, no evidence of barotrauma was revealed by CT imaging following MRS and no clinical complications that could be associated with MRS were detected.

These results differ significantly from a previous study by Gattinoni and colleagues (2006), possibly because the methodology and patient population differed. For example, Gattinoni and colleagues used a low PEEP (5 cmH2O) between recruitment phase steps. In addition, the patients may have suffered from more severe ventilation trauma as indicated by a mean ventilation period of 5 days before recruitment into the study. In the present study, patients were recruited into the study within 72 hours of ARDS onset and a PEEP of 10 cmH2O was maintained between the recruitment phase steps. These differences, de Matos and colleagues (2012) suggest, explain why Gattinoni and colleagues found a mean value for potential recruitable lung tissue of only 13 ± 11%.

Notably, the findings of de Matos and colleagues (2012) suggest that baseline CT scans, or the amount of non-aerated tissue, cannot reliably predict an individual patient's response to the MRS maneuver. In other words, the severity of ARDS is not predictive of the efficacy of an MRS intervention as designed by de Matos and colleagues. This explains why no correlation was found between mortality and lung recruitment potential as revealed by MRS maneuvers.

Summary

Mechanical ventilation of patients suffering from ARDS has historically been associated with a high mortality rate. Although several studies have investigated lung recruitment strategies, none had achieved significant improvement in lung recruitment without causing additional tissue damage. A recent study by de Matos and colleagues (2012) utilizing MRS may have ended this history of marginal success, by showing that potential recruitable lung ranged between 25% and 53% (median 45%). Early and aggressive intervention using MRS therefore appears to represent a method of lung recruitment that successfully limits the damage caused by mechanical ventilation in ARDS patients.

References

de Matos, Gustavo F.J., Stanzani, Fabiana, Passos, Rogerio H., Fontana, Mauricio F., Albaladejo, Renata, Caserta, Raquel E. et al. (2012). How large is the lung recruitability in early ARDS: A prospective case series of patients monitored by CT. Critical Care, 16, 1-14.

Gattinoni, Luciano, Caironi, Pietro, Cressoni, Massimo, Chiumello, Davide, Ranieri, V. Marco, Quintel, Michael et al. (2006). Lung recruitment in patients with the acute respiratory distress syndrome. New England Journal… [END OF PREVIEW]

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APA Format

Lung Recruitability in Early.  (2012, March 26).  Retrieved December 9, 2019, from https://www.essaytown.com/subjects/paper/lung-recruitability-early/5993407

MLA Format

"Lung Recruitability in Early."  26 March 2012.  Web.  9 December 2019. <https://www.essaytown.com/subjects/paper/lung-recruitability-early/5993407>.

Chicago Format

"Lung Recruitability in Early."  Essaytown.com.  March 26, 2012.  Accessed December 9, 2019.
https://www.essaytown.com/subjects/paper/lung-recruitability-early/5993407.