Assessment of the Effect of Recruitment Maneuver on Lung Aeration Through Imaging Analysis in Invasively Ventilated Patients: A Systematic Review

Bibliographic Details
Title: Assessment of the Effect of Recruitment Maneuver on Lung Aeration Through Imaging Analysis in Invasively Ventilated Patients: A Systematic Review
Authors: Charalampos Pierrakos, Marry R. Smit, Laura A. Hagens, Nanon F. L. Heijnen, Markus W. Hollmann, Marcus J. Schultz, Frederique Paulus, Lieuwe D. J. Bos
Source: Frontiers in Physiology, Vol 12 (2021)
Publisher Information: Frontiers Media S.A., 2021.
Publication Year: 2021
Collection: LCC:Physiology
Subject Terms: electrical impedance tomography, computed tomography, lung ultrasound, overdistention, recruitment maneuvers, ARDS, Physiology, QP1-981
More Details: Background: Recruitment maneuvers (RMs) have heterogeneous effects on lung aeration and have adverse side effects. We aimed to identify morphological, anatomical, and functional imaging characteristics that might be used to predict the RMs on lung aeration in invasively ventilated patients.Methods: We performed a systemic review. Studies included invasively ventilated patients who received an RM and in whom re-aeration was examined with chest computed tomography (CT), electrical impedance tomography (EIT), and lung ultrasound (LUS) were included.Results: Twenty studies were identified. Different types of RMs were applied. The amount of re-aerated lung tissue after an RM was highly variable between patients in all studies, irrespective of the used imaging technique and the type of patients (ARDS or non-ARDS). Imaging findings suggesting a non-focal morphology (i.e., radiologic findings consistent with attenuations with diffuse or patchy loss of aeration) were associated with higher likelihood of recruitment and lower chance of overdistention than a focal morphology (i.e., radiological findings suggestive of lobar or segmental loss of aeration). This was independent of the used imaging technique but only observed in patients with ARDS. In patients without ARDS, the results were inconclusive.Conclusions: ARDS patients with imaging findings suggestive of non-focal morphology show most re-aeration of previously consolidated lung tissue after RMs. The role of imaging techniques in predicting the effect of RMs on re-aeration in patients without ARDS remains uncertain.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1664-042X
Relation: https://www.frontiersin.org/articles/10.3389/fphys.2021.666941/full; https://doaj.org/toc/1664-042X
DOI: 10.3389/fphys.2021.666941
Access URL: https://doaj.org/article/c0d096c2f65f49bf825c824416d351a4
Accession Number: edsdoj.0d096c2f65f49bf825c824416d351a4
Database: Directory of Open Access Journals
More Details
ISSN:1664042X
DOI:10.3389/fphys.2021.666941
Published in:Frontiers in Physiology
Language:English