Lung Recruitment in Patients with ARDS

To the Editor: In the April 27 issue, Gattinoni et al. 1 suggest that the potential for lung recruitment in patients with acute lung injury is generally low and extremely variable among patients. We believe that a suboptimal recruitment maneuver explains such results, contradicting investigations 2...

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Published inThe New England journal of medicine Vol. 355; no. 3; pp. 319 - 322
Main Authors Borges, João B, Carvalho, Carlos R R, Amato, Marcelo B P
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 20.07.2006
Subjects
Humans
Lung - physiopathology
Positive-Pressure Respiration
Respiratory Distress Syndrome, Adult - physiopathology
Respiratory Distress Syndrome, Adult - therapy
Tidal Volume
Total Lung Capacity
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Summary:To the Editor: In the April 27 issue, Gattinoni et al. 1 suggest that the potential for lung recruitment in patients with acute lung injury is generally low and extremely variable among patients. We believe that a suboptimal recruitment maneuver explains such results, contradicting investigations 2 – 4 that demonstrate a much larger potential for recruitment and greater homogeneity of response. Gattinoni et al. used an inspiratory plateau pressure of 45 cm of water, a pressure certainly below the critical opening pressures reported in recent studies 2 – 4 in humans. The investigators also allowed expiratory pressures to repeatedly fall to 5 cm of water, . . .
Bibliography:SourceType-Other Sources-1
content type line 63
ObjectType-Correspondence-1
ObjectType-Commentary-2
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJMc061434