Lung recruitment in patients with the acute respiratory distress syndrome

Luciano Gattinoni, Pietro Caironi, Massimo Cressoni, Davide Chiumello, V. Marco Ranieri, Michael Quintel, Sebastiano Russo, Nicolò Patroniti, Rodrigo Cornejo, Guillermo Bugedo

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Abstract

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

Original languageEnglish
Pages (from-to)1775-1786
Number of pages12
JournalNew England Journal of Medicine
Volume354
Issue number17
DOIs
Publication statusPublished - Apr 27 2006

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ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gattinoni, L., Caironi, P., Cressoni, M., Chiumello, D., Ranieri, V. M., Quintel, M., Russo, S., Patroniti, N., Cornejo, R., & Bugedo, G. (2006). Lung recruitment in patients with the acute respiratory distress syndrome. New England Journal of Medicine, 354(17), 1775-1786. https://doi.org/10.1056/NEJMoa052052