肺泡撐開法

The pathobiology of acute respiratory distress syndrome (ARDS) has a natural tendency to collapse. Recruitment maneuver, an 'open lung strategy' focusing on alveolar patency, has its pathophysiologic rationale. Various recruitment maneuvers exist, including sustained inflation to high pressures, intermittent sighs, and stepwise increases in positive end-expiratory pressure (PEEP) or peak inspiratory pressure.
Data regarding the use of recruitment maneuvers in patients with ARDS show mixed results, with increased efficacy in those with early stage of ARDS, good compliance of the chest wall, Low PEEP, and in extrapulmonary ARDS. Patients with ARDS who are ventilated with high tidal volumes or high levels of PEEP are less apt to derecruitment and may not exhibit a response to recruiting interventions.
In this review we discuss the pathophysiologic basis for the use of recruitment maneuvers, recent evidence in acute lung injury, as well as the adverse event of the technique.