Respiratory failure & ventilation
Respiratory effects of recruitment maneuvers according to lung recruitability assessed by electrical impedance tomography in patients with acute respiratory distress syndrome
Authors' conclusion
A strategy combining a RM with subsequent individualized EIT-guided PEEP titration was associated with improved oxygenation and lung mechanics in patients with high lung recruitability, whereas patients with low recruitability showed limited physiological benefit, with cardiorespiratory adverse events appearing numerically more frequent.
Study context
- Population
- Patients with moderate-to-severe acute respiratory distress syndrome (ARDS)
- Participants
- 50 patients
- Comparison
- Before vs after stepwise recruitment maneuvers (RM) followed by electrical impedance tomography (EIT)-guided PEEP titration, by high vs low lung recruitability
Methodological detailssubgroup analysis by lung recruitability (EIT)
- Subgroup analysis by lung recruitability (EIT)
Primary result
As reported in the abstract
PaO₂/FiO₂, high recruitability (before vs after)
100.8 ± 30.3 vs. 125.4 ± 38.3 mmHg (P < 0.05)
mean ± SD as printed
Cstat, high recruitability (before vs after)
21.5 ± 5.8 vs. 28.0 ± 7.0 mL/cmH₂O (P < 0.001)
PaO₂/FiO₂, Cstat and Pdriv before vs after RM, by recruitability subgroup
Pdriv, high recruitability (before vs after)
19.1 ± 3.5 vs. 15.6 ± 3.2 cmH₂O (P < 0.001)
PaO₂/FiO₂, Cstat and Pdriv before vs after RM, by recruitability subgroup
Further findings
ICU mortality
- Similar between groups
Safety
Cardiorespiratory adverse events (transient hypotension, arrhythmia, desaturation)
- Numerically more common in the low-recruitability group
- No barotrauma or cardiac arrest occurred
- ICU mortality similar between groups
Original publication
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