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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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SUPPORT VENTILATION  SMART 2002 Milan, May 29-31, 2002

Minerva Anestesiologica 2002 May;68(5):351-5

language: English

Lung recruitment in unilateral lung disease

Blanch L., Murias G. *, Nahum A. **

From the Critical Care Center Hospital de Sabadell Corporació Parc Tauli University Institute (UAB), Sabadell, Spain
*Catedra de Farmacologia Facultad de Ciencias Medicas Universidad Nacional de La Plata La Plata, Argentina
**Department of Pulmonary and Critical Care Medicine University of Minnesota, Regions Hospital St. Paul, Minnesota, USA


The treat­ment of uni­lat­er­al ­lung inju­ry is sup­por­tive. Gas ­exchange can be ­improves by posi­tion­ing the ­patient ­with the “­good ­lung ­down” and apply­ing dif­fe­ren­tial ven­ti­la­tion ­with selec­tive ­PEEP in ­some ­patients. How­ev­er, ­both strat­e­gies ­have seri­ous lim­i­ta­tions in clin­i­cal prac­tice. ­Basic ­research ­have ­shown ­that the appli­ca­tion of selec­tive TGI and the com­bi­na­tion of selec­tive TGI and PLV per­mit­ted a reduc­tion in ­tidal vol­ume ­with resul­tant ­decrease in air­way pres­sures and improve­ment in ­lung com­pli­ance, with­out any ­adverse ­effects on CO2 elim­i­na­tion. Experi­men­tal mod­els ­have ­shown ­that the use of selec­tive TGI and PLV at low ­tidal vol­ume is a sim­ple meth­od to pro­vide region­al recruit­ment, enhanc­ing gas ­exchange ­while reduc­ing ­cyclic ­lung ­stretch and ­shear stress­es asso­ciat­ed ­with mechan­i­cal ven­ti­la­tion. ­These experi­men­tal stud­ies can­not be extrap­o­lat­ed to clin­i­cal prac­tice ­because fur­ther stud­ies are need­ed to deter­mine ­human appli­ca­tions of ­these ther­a­pies.

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