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A recruitment breath manoeuvre directly after endotracheal suction improves lung function: an experimental study in pigs
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
Department of Pathology, Gävle Hospital, Gävle, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
2009 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 114, no 3, 129-135 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Atelectasis occurs after a well performed endotracheal suction. Clinical studies have shown that recruitment manoeuvres added after endotracheal suction during mechanical ventilation restore lung function. Repetitive lung over-distension is, however, harmful for the lung, and the effects of adding a larger breath, recruitment breath, directly after repeated endotracheal suction were therefore investigated.

METHODS: Twelve healthy anaesthetized pigs were randomized into two groups: one without and one with a recruitment breath manoeuvre (RBM), i.e. a breath 15 cmH(2)O above inspiratory pressure for 10 s during pressure-controlled ventilation. The pigs were suctioned every hour for 4 hours with an open suction system.

RESULTS: At the end of the study there was a statistically significant difference between the group given RBM and that without with respect to PaCO(2), tidal volume (V(T)), and compliance (Crs). Without RBM, the PaCO(2) increased from 4.6+/-0.4 to 6.1+/-1.5 kPa, V(T) decreased from 345+/-39 to 247+/-71 mL, and Crs decreased from 28+/-6 to 18+/-5 mL/cmH(2)O. There was no change in PaCO(2) or Crs when a RBM was given. Morphological analysis revealed no differences in aeration of apical and central lung parenchyma. In the basal lung parenchyma there were, however, greater areas with normal lung parenchyma and less atelectasis after RBM.

CONCLUSIONS: Atelectasis created by endotracheal suction can be opened by inflating the lung for a short duration with low pressure, without over-distension, immediately after suction.

Place, publisher, year, edition, pages
2009. Vol. 114, no 3, 129-135 p.
Keyword [en]
atelectasis, histology, lung, mechanical, ventilation, pigs, recruitment, suction
National Category
Medical and Health Sciences
Research subject
Lung Medicine; Pathology
Identifiers
URN: urn:nbn:se:uu:diva-125865DOI: 10.1080/03009730903177357ISI: 000269606400001PubMedID: 19736601OAI: oai:DiVA.org:uu-125865DiVA: diva2:321112
Available from: 2010-05-28 Created: 2010-05-28 Last updated: 2012-08-24Bibliographically approved

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Högman, Marieann

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