TY - JOUR
T1 - Lung recruitment in patients with the acute respiratory distress syndrome
AU - Gattinoni, Luciano
AU - Caironi, Pietro
AU - Cressoni, Massimo
AU - Chiumello, Davide
AU - Ranieri, V. Marco
AU - Quintel, Michael
AU - Russo, Sebastiano
AU - Patroniti, Nicolò
AU - Cornejo, Rodrigo
AU - Bugedo, Guillermo
PY - 2006/4/27
Y1 - 2006/4/27
N2 - BACKGROUND: In the acute respiratory distress syndrome (ARDS), positive end-expiratory pressure (PEEP) may decrease ventilator-induced lung injury by keeping lung regions open that otherwise would be collapsed. Since the effects of PEEP probably depend on the recruitability of lung tissue, we conducted a study to examine the relationship between the percentage of potentially recruitable lung, as indicated by computed tomography (CT), and the clinical and physiological effects of PEEP. METHODS: Sixty-eight patients with acute lung injury or ARDS underwent whole-lung CT during breath-holding sessions at airway pressures of 5, 15, and 45 cm of water. The percentage of potentially recruitable lung was defined as the proportion of lung tissue in which aeration was restored at airway pressures between 5 and 45 cm of water. RESULTS: The percentage of potentially recruitable lung varied widely in the population, accounting for a mean (±SD) of 13±11 percent of the lung weight, and was highly correlated with the percentage of lung tissue in which aeration was maintained after the application of PEEP (r 2 = 0.72, P
AB - BACKGROUND: In the acute respiratory distress syndrome (ARDS), positive end-expiratory pressure (PEEP) may decrease ventilator-induced lung injury by keeping lung regions open that otherwise would be collapsed. Since the effects of PEEP probably depend on the recruitability of lung tissue, we conducted a study to examine the relationship between the percentage of potentially recruitable lung, as indicated by computed tomography (CT), and the clinical and physiological effects of PEEP. METHODS: Sixty-eight patients with acute lung injury or ARDS underwent whole-lung CT during breath-holding sessions at airway pressures of 5, 15, and 45 cm of water. The percentage of potentially recruitable lung was defined as the proportion of lung tissue in which aeration was restored at airway pressures between 5 and 45 cm of water. RESULTS: The percentage of potentially recruitable lung varied widely in the population, accounting for a mean (±SD) of 13±11 percent of the lung weight, and was highly correlated with the percentage of lung tissue in which aeration was maintained after the application of PEEP (r 2 = 0.72, P
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U2 - 10.1056/NEJMoa052052
DO - 10.1056/NEJMoa052052
M3 - Article
C2 - 16641394
AN - SCOPUS:33646115657
VL - 354
SP - 1775
EP - 1786
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 17
ER -