• Balkan medical journal · Jun 2013

    Recruitment Maneuver Does not Increase the Risk of Ventilator Induced Lung Injury.

    • Ibrahim Özkan Akıncı, Korkut Atalan, Simru Tuğrul, Perihan Ergin Ozcan, Dilek Yılmazbayhan, Bayram Kıran, Ahmet Basel, Lutfi Telci, and Nahit Cakar.
    • Department of Anaesthesiology and Intensive care, İstanbul University İstanbul Medical Faculty, İstanbul, Turkey.
    • Balkan Med J. 2013 Jun 1;30(2):229-34.

    BackgroundMechanical ventilation (MV) may induce lung injury.AimsTo assess and evaluate the role of different mechanical ventilation strategies on ventilator-induced lung injury (VILI) in comparison to a strategy which includes recruitment manoeuvre (RM).Study DesignRandomized animal experiment.MethodsThirty male Sprague-Dawley rats were anaesthetised, tracheostomised and divided into 5 groups randomly according to driving pressures; these were mechanically ventilated with following peak alveolar opening (Pao) and positive end-expiratory pressures (PEEP) for 1 hour: Group 15-0: 15 cmH2O Pao and 0 cmH2O PEEP; Group 30-10: 30 cmH2O Pao and 10 cmH2O PEEP; Group 30-5: 30 cmH2O Pao and 5 cmH2O PEEP; Group 30-5&RM: 30 cmH2O Pao and 5 cmH2O PEEP with additional 45 cmH2O CPAP for 30 seconds in every 15 minutes; Group 45-0: 45 cmH2O Pao and 0 cmH2O PEEP Before rats were sacrificed, blood samples were obtained for the evaluation of cytokine and chemokine levels; then, the lungs were subsequently processed for morphologic evaluation.ResultsOxygenation results were similar in all groups; however, the groups were lined as follows according to the increasing severity of morphometric evaluation parameters: Group 15-0: (0±0.009) < Group 30-10: (0±0.14) < Group 30-5&RM: (1±0.12) < Group 30-5: (1±0.16) < Group 45-0: (2±0.16). Besides, inflammatory responses were the lowest in 30-5&RM group compared to all other groups. TNF-α, IL-1β, IL-6, MCP-1 levels were significantly different between group 30-5&RM and group 15-0 vs. group 45-0 in each group.ConclusionRM with low PEEP reduces the risk of ventilator-induced lung injury with a lower release of systemic inflammatory mediators in response to mechanical ventilation.

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