Cardiothoracic & vascular anesthesia
Negative extra-abdominal pressure (NEXAP)-based lung recruitment maneuver versus standard lung recruitment maneuver in the treatment of postoperative atelectasis after cardiac surgery: A single-center randomized controlled trial
Authors' conclusion
NEXAP is an effective treatment for atelectasis after cardiac surgery, which significantly reduced patients' LUSS, improved pulmonary ventilation (especially in the lateral and posterior regions). NEXAP can further reduce LUSStot than the traditional PEEP-based LRM.
Study context
- Population
- Patients with atelectasis after cardiac surgery
- Participants
- 29 vs 33
- Comparison
- NEXAP-based lung recruitment maneuver (LRM) vs stepwise positive end-expiratory pressure (PEEP)-based LRM
- NEXAPn = 29
- PEEPn = 33reference
- Primary endpoint
- Lung ultrasound score (LUSS), global (LUSStot) and regional (posterior, anterior, lateral)
Methodological detailssingle-centre
- Single-centre
Primary result
As reported in the abstract
Change in LUSStot after LRM (ΔLUSStot)
| Group | Value | LUSStot before vs after LRM |
|---|---|---|
| NEXAP | −5.1 (SD 2.3) | 20.7 ± 3.2 vs. 15.6 ± 3.3; p < 0.001 |
| PEEP | −3.8 (SD 2.2) | 21.5 ± 4.2 vs. 17.1 ± 4.6; p < 0.001 |
Value
NEXAP−5.1 (SD 2.3)
PEEP−3.8 (SD 2.2)
LUSStot before vs after LRM
NEXAP20.7 ± 3.2 vs. 15.6 ± 3.3; p < 0.001
PEEP21.5 ± 4.2 vs. 17.1 ± 4.6; p < 0.001
- NEXAP vs PEEP: P = 0.020 — ΔLUSStot significantly greater with NEXAP
Further findings
PaO2/FiO2, PaO2, Vt and Crs
- Significantly improved in both groups
Original publication
Negative extra-abdominal pressure (NEXAP)-based lung recruitment maneuver versus standard lung recruitment maneuver in the treatment of postoperative atelectasis after cardiac surgery: A single-center randomized controlled trial. J Crit Care. Published 22 May 2025. doi:10.
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