Recruitment techniques

A number of techniques are described to recruit collapsed alveoli, such as applying 40cmH2O PEEP for 40s with no ventilator breaths; delivering a few large-volume, ventilator-delivered breaths; or by using a combination of varying levels of PEEP and increasing pressure-delivered breaths to obtain optimal gas exchange.

Although anecdotal successes are reported, with occasionally dramatic improvements in lung compliance and gas exchange, no comparative trials have been performed, and outcomes have not been assessed prospectively. Haemodynamic compromise may occur during the procedure, though this usually recovers on cessation.

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