"To our knowledge, this is the first study to show a significant effect of lung recruitment manoeuvres on clinical outcomes, which objectively resulted in modest reductions in ICU and hospital length of stay with no difference in in-hospital mortality or the occurrence of barotrauma," the authors write. In this trial, conducted by Alcino Costa Leme, RRT, PhD (Hospital Das Clínicas da FMUSP, University of São Paulo, Brazil) and colleagues, postoperative ventilation with a high PEEP level (157 patients) compared with a lower PEEP level (163 patients) resulted in a significant shift toward less severe pulmonary complications and was associated with a shorter length of intensive care unit stay (3.8 vs. But, these “one size fits all” recommendations may not be optimal for all patients. Thus, current guidelines endorse a low tidal volume and a high or at least avoidance of low PEEP level. However, both the volume and pressure settings on a ventilator have been implicated in ventilator-induced lung injury, with tidal volumes that are too large implicated in overdistension and positive end-expiratory pressure (PEEP) settings that are too low implicated in alveolar collapse. Mechanical ventilation is an effective life-support treatment. See Also: Towards Safer Ventilation in Critically ill Patients without ARDS
PIP IN MECHANICAL VENTILATION TRIAL
Among patients with hypoxaemia after cardiac surgery, the use of an intensive alveolar recruitment strategy compared with a moderate recruitment strategy resulted in less severe pulmonary complications during the hospital stay, according to a randomised clinical trial of postoperative ventilation published in JAMA.
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