title: Post-suction recruitment manoeuvre restores lung function in healthy, anaesthetized pigs.
abstract: Endotracheal suction can cause partial lung collapse and hypoxia and alter lung mechanics. We investigated the effects of adding a recruitment manoeuvre directly after endotracheal suction to restore lung volume in volume-controlled ventilation and pressure-controlled ventilation modes. Five anaesthetized pigs were investigated. The effects of endotracheal suction with or without a recruitment manoeuvre were compared in random order. In volume-controlled ventilation, compliance decreased after suction from 33 +/- 5 to 26 +/- 6 ml x cmH2O(-1) (P<0.05), and 30 minutes later it remained decreased at 25 +/- 6 ml x cmH2O(-1). Venous admixture increased after suction from 5 +/- 2 to 8 +/- 4% (P<0.05), but had recovered at 30 minutes. In pressure-controlled ventilation, compliance decreased after suction from 34 +/- 3 to 25 +/- 7 ml x cmH2O(-1) (P<0.05), and 30 minutes later it remained decreased at 25 +/- 7 ml x cmH2O(-1). Venous admixture increased after suction from 5 +/- 2 to 13 +/- 7% (P<0.05), and had not recovered after 30 minutes, 10 +/- 4%. When a recruitment manoeuvre was applied directly after suction, no negative side-effects were registered in volume-controlled ventilation or pressure-controlled ventilation. We conclude that the impairment of lung mechanics and gas exchange induced by endotracheal suction can be prevented by a simple post-suction recruitment manoeuvre. Further studies are needed to identify a suitable suction recruitment manoeuvre in patients with diseased lungs.
authors.affiliation: Department of Medical Cell Biology, Section of Integrative Physiology, Uppsala University, Uppsala, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Almgren
authors.forename: C J
authors.initials: CJ
authors.lastname: Wickerts
authors.forename: M
authors.initials: M
authors.lastname: Hogman
mesh_terms: D000818:Animals; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008170:Lung Compliance; D008176:Lung Volume Measurements; D011175:Positive-Pressure Respiration; D001261:Pulmonary Atelectasis / Q000209:etiology / Q000517:prevention & control; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial; D013396:Suction / Q000009:adverse effects; D013552:Swine