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Lung recruitment techniques in the ICU 

Lung recruitment techniques in the ICU
Lung recruitment techniques in the ICU

Thomas Kiss

and Paolo Pelosi

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date: 26 February 2020

Lung recruitment manoeuvres (RMs) have been suggested as a means of homogenizing the lung structure and distribution of the mechanical stress across the lungs. Such effects can be achieved provided enough pressure is applied for enough time at the airways, and maintained if adequate levels of positive end-expiratory pressure (PEEP) are used. When RMs effectively open atelectatic tissue, shear stress, and cyclic collapse/reopening are importantly reduced. The lung response to RMs is mainly determined by cause and severity of lung injury, and the position of the lungs with respect to the gravity gradient. RMs can be performed in several different ways, the most relevant RMs in terms of clinical applicability are sustained inflation manoeuvres, high pressure controlled ventilation, incremental PEEP, and intermittent sighs.

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