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Maximal recruitment strategy guided by thoracic CT scan in severe acute respiratory distress syndrome patients: a case series report
Critical Care volume 11, Article number: P188 (2007)
There is great controversy concerning protective ventilation in ARDS. Recruitment maneuvers and PEEP titration sufficient to avoid collapse and tidal recruitment are the major goals of the maximal recruitment strategy (MRS).
To describe clinical and demographic data. To evaluate the incidence of complications related to transportation and to the MRS.
Forty-three patients with ARDS were transported to CT and submitted to the MRS, which consisted of 2-minute steps of ventilation with a fixed PCV = 15 cmH2O and progressive PEEP levels (10-45-25-10 cmH2O), RR = 10, I:E = 1:1, and FiO2 = 1.0. Opening (recruitment) and closing (PEEP titration) pressures were determined according to the least amount of collapse observed at the CT, and were used to ventilate the patients afterwards.
Clinical data are presented in Table 1. There were no complications due to transportation and one patient developed pneumomediatinum after the protocol.
MRS was well tolerated in this series of patients, rendered the gas distribution through the lung more homogeneous, improved gas exchange and was related to low mortality. A RCT to test the MRS is necessary.
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De Matos, G., Borges, J., Meyer, E. et al. Maximal recruitment strategy guided by thoracic CT scan in severe acute respiratory distress syndrome patients: a case series report. Crit Care 11, P188 (2007). https://doi.org/10.1186/cc5348
- Respiratory Distress Syndrome
- Distress Syndrome
- Acute Respiratory Distress Syndrome
- Syndrome Patient
- Acute Respiratory Distress Syndrome Patient