title: Alveolar recruitment strategy increases arterial oxygenation during one-lung ventilation.
abstract: BACKGROUND
  Deterioration of gas exchange during one lung ventilation (OLV) is caused by both total collapse of the nondependent lung and partial collapse of the dependent lung. A previous report demonstrated that an alveolar recruitment strategy (ARS) improves lung function during general anesthesia in supine patients. The objective of this article was to study the impact of this ARS on arterial oxygenation in patients undergoing OLV for lobectomies.
  
  
  METHODS
  Ten patients undergoing open lobectomies were studied at three time points: (1) during two-lung ventilation (TLV), (2) during OLV before, and (3) after ARS. The ARS maneuver was done by increasing peak inspiratory pressure to 40 cm H2O, together with a positive end-expiratory pressure (PEEP) of 20 cm H2O for 10 respiratory cycles. After the maneuver, ventilation parameters were returned to the settings before intervention.
  
  
  RESULTS
  During OLV, PaO2 was statistically lower before the recruitment (data as median, first, and third quartile, 217 [range 134 to 325] mm Hg) compared with OLV afterwards (470 [range 396 to 525] mm Hg) and with TLV (515 [range 442 to 532] mm Hg). After ARS, PaO2 values during OLV were similar to those during TLV. During OLV, the degree of pulmonary collapse in the nondependent lung, the hemodynamic status, and the ventilation parameters were similar before and after ARS.
  
  
  CONCLUSIONS
  Alveolar recruitment of the dependent lung augments PaO2 values during one-lung ventilation.
authors: Department of Anesthesiology, Hospital Privado de Comunidad, Mar del Plata, Argentina. gtusman@hotmail.com
authors: Gerardo
authors: G
authors: Tusman
authors: Stephan H
authors: SH
authors: Böhm
authors: Fernando
authors: F
authors: Melkun
authors: Daniel
authors: D
authors: Staltari
authors: Carlos
authors: C
authors: Quinzio
authors: Carlos
authors: C
authors: Nador
authors: Elsio
authors: E
authors: Turchetto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D011013:Pneumonectomy; D011175:Positive-Pressure Respiration; D011446:Prospective Studies; D011650:Pulmonary Alveoli / Q000502:physiology*; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial / Q000379:methods*
chemical_list: D010100:Oxygen