Post–suction Recruitment Manoeuvre Restores Lung Function in Healthy, Anaesthetized Pigs

Author:

Almgren B.12,Wickerts C-J.13,Hogman M.14

Affiliation:

1. Department of Medical Cell Biology, Section of Integrative Physiology, Uppsala University, Uppsala and Karolinska Institute, Division of Anesthesia and Intensive Care, Danderyd Hospital, Stockholm, Sweden

2. Department of Medical Cell Biology, Section of Integrative Physiology, Uppsala University, Uppsala and Karolinska Institute, Division of Anesthesia and Intensive Care, Danderyd Hospital, Stockholm.

3. Karolinska Institute, Division of Anesthesia and Intensive Care, Danderyd Hospital, Stockholm.

4. Department of Medical Cell Biology, Section of Integrative Physiology, Uppsala University, Uppsala.

Abstract

Endotracheal suction can cause partial lung collapse and hypoxia and alter lung mechanics. We investigated the effects of adding a recruitment manoeuvre directly after endotracheal suction to restore lung volume in volume-controlled ventilation and pressure-controlled ventilation modes. Five anaesthetized pigs were investigated. The effects of endotracheal suction with or without a recruitment manoeuvre were compared in random order. In volume-controlled ventilation, compliance decreased after suction from 33±5 to 26±6 ml.cmH2O–1 (P<0.05), and 30 minutes later it remained decreased at 25±6 ml.cmH2O–1. Venous admixture increased after suction from 5±2 to 8±4% (P<0.05), but had recovered at 30 minutes. In pressure-controlled ventilation, compliance decreased after suction from 34±3 to 25±7 ml.cmH2O–1 (P<0.05), and 30 minutes later it remained decreased at 25±7 ml.cmH2O–1. Venous admixture increased after suction from 5±2 to 13±7% (P<0.05), and had not recovered after 30 minutes, 10±4%. When a recruitment manoeuvre was applied directly after suction, no negative side-effects were registered in volume-controlled ventilation or pressure-controlled ventilation. We conclude that the impairment of lung mechanics and gas exchange induced by endotracheal suction can be prevented by a simple post-suction recruitment manoeuvre. Further studies are needed to identify a suitable suction recruitment manoeuvre in patients with diseased lungs.

Publisher

SAGE Publications

Subject

Anesthesiology and Pain Medicine,Critical Care and Intensive Care Medicine

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