Lung recruitment in unilateral lung disease.
The treatment of unilateral lung injury is supportive. Gas exchange can be improves by positioning the patient with the "good lung down" and applying differential ventilation with selective PEEP in some patients. However, both strategies have serious limitations in clinical practice. Basic research have shown that the application of selective TGI and the combination of selective TGI and PLV permitted a reduction in tidal volume with resultant decrease in airway pressures and improvement in lung compliance, without any adverse effects on CO2 elimination. Experimental models have shown that the use of selective TGI and PLV at low tidal volume is a simple method to provide regional recruitment, enhancing gas exchange while reducing cyclic lung stretch and shear stresses associated with mechanical ventilation. These experimental studies cannot be extrapolated to clinical practice because further studies are needed to determine human applications of these therapies.
Blanch
L
L
Critical Care Center, Hospital de Sabadell, Corporació Parc Tauli, University Institute (UAB), Sabadell, Spain. lblanch@cspt.es
Murias
G
G
Nahum
A
A
D006801:Humans; D021061:Liquid Ventilation; D008171:Lung Diseases / Q000503:physiopathology / Q000628:therapy*; D011175:Positive-Pressure Respiration; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy; D014132:Trachea / Q000502:physiology