Effect of the alveolar recruitment manoeuvre on haemodynamic parameters in patients with acute respiratory distress syndrome: relationship with oxygenation |
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Authors: | Huh Jin Won Hong Sang-Bum Lim Chae-Man Koh Younsuck |
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Affiliation: | Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Songpa-gu, Seoul, Korea. |
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Abstract: | ![]() Background and objective: Although the alveolar recruitment manoeuvre (ARM) is considered to be an optimal method of recruiting collapsed alveoli in a short period, the haemodynamic effects of the ARM have not been investigated. The aim of this study was to assess whether the ARM causes haemodynamic instability in patients with ARDS, and any relationship this might have with arterial oxygenation. Methods: Twenty‐eight patients with ARDS (16 responders and 12 non‐responders), who were admitted to the medical intensive care unit of a university‐affiliated hospital, were enrolled in the study. ARM, using the extended sigh method, was performed within 48 h of the onset of ARDS. Haemodynamic parameters were measured at baseline, during the ARM, and at 2 min, 30 min and 1 h after the ARM. Results: Responders and non‐responders showed no significant changes in blood pressure or cardiac index during or after ARM. Mean pulmonary artery pressure (MPAP), pulmonary vascular resistance index (PVRI) and right ventricular stroke work index (RVSWI) were transiently increased compared with baseline, in responders and non‐responders. During and after ARM, the systemic vascular resistance index was significantly higher in non‐responders than in responders. Conclusions: Some haemodynamic parameters (MPAP, PVRI and RVSWI) changed significantly during ARM. However, these haemodynamic changes were minimal, transient and probably have no clinical significance. |
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Keywords: | acute respiratory distress syndrome alveolar recruitment manoeuvre cardiac output haemodynamic effect |
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