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1 Department of Medicine, Vermont Lung Center, University of Vermont, Burlington, Vermont 05405; and 2 Department of Clinical Physiology, Malmö University Hospital, Lund University, 20512 Malmö, Sweden
The lasting effects of a recruitment
maneuver (RM) in the injured lung are not well characterized. We
speculated that the reduction in respiratory elastance (H)
after a deep inflation (DI) is transient in nature and should be
sustained longer at higher positive end-expiratory pressure (PEEP).
Thirteen ventilated mice were given 2 DIs at various levels of PEEP
before and after saline lavage. Forced oscillations were used to
measure H periodically over 7 min after the DIs. Time
constants (
) were estimated for the post-DI recovery in
H. Values for
before lavage (80-115 s) were reduced
after lavage (13-30 s) at all levels of PEEP (P = 0.0001). PEEP did not significantly influence
before or after lavage. The plateau level and total recovery in H after a DI
were significantly influenced by PEEP and lavage (P < 0.0001). Our results suggest that for a DI to be beneficial in the
injured mouse lung, it may have to be applied several times a minute.
atelectasis; acute lung injury; recruitment; elastance; positive-pressure respiration
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