Effects of Lung Recruitment Maneuvers in Patients with Acute Respiration Distress Syndrome

Objective To investigate the clinical effects, therapy safety and maintenance time of recruitment maneuvers (RM) combined with lung protective strategy in patients with acute respiratory distress syndrome (ARDS). Methods Thirty-two ventilated patients with ARDS underwent RM using a pressure of 30cmH_2O for 30s, without any sedatives and neuromuscular blocking agents. Results Compared with before RM, both oxhemoglobin saturation measured by pulse oximetry (SpO_2) and partial pressure of arterial oxygen (PaO_2) were significantly increased during one hour after applying RM. SpO_2 increased significantly within two hours after RM. The peak inspiratory pressures (PIP), heart rate (HR) and Pplateau inspiratory pressures (Pplate) had not significant difference between after and before RM, but respiratory system compliance (Crs) increased markedly in one hour after RM (P0.05). The central vein pressure (CVP) and mean arterial pressure (MAP) improved significantly in 30s after RM (P0.05), but no significant difference in 10 min. When lung injury score (LIS) was less than 3.0, PaO_2/FiO_2 improved markedly and the maintain time was more than four hours, but when LIS was more than 3.6, the maintain time was less than 30 min. Conclusion RM could improve oxygention, Crs and the maintain time of the patients with ARDS, but the effects were related to the serious degree of ARDS. This study also suggested that RM could be safe and effective on hemodynamics.