title: Effects of a single-lung recruitment maneuver on the systemic release of inflammatory mediators.
abstract: OBJECTIVE
  To study the hypothesis, that systemic levels of pro-inflammatory and anti-inflammatory cytokines may be affected by a single recruitment maneuver in mechanically ventilated patients.
  
  
  METHODS
  Prospective, interventional clinical trial.
  
  
  METHODS
  Intensive care unit of a university hospital.
  
  
  METHODS
  Sixteen mechanically ventilated patients with clinical and radiological signs of atelectasis.
  
  
  METHODS
  A single recruitment maneuver (RM) was performed by elevating the airway pressure to 40 cmH(2)O for 7s.
  
  
  RESULTS
  Plasmatic concentrations of interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12p70 and tumor necrosis factor (TNF-alpha), arterial blood gases and hemodynamic parameters were measured immediately before and 5-360 min after the RM. The RM caused a minor, nevertheless significant improvement of oxygenation (p = 0.02) and carbon dioxide elimination (p=0.006) as well as a moderate drop of the mean arterial pressure (p=0.025). In contrast, plasma concentrations remained unaffected by the RM in all six mediators measured.
  
  
  CONCLUSIONS
  A single inflation with an airway pressure of 40cmH(2)O for 7 s improved gas exchange only slightly and did not modify systemic levels of inflammatory mediators in mechanically ventilated patients with radiological evidence of atelectasis.
authors.affiliation: Zentrum Anaesthesie, Rettungs- und Intensivmedizin, Georg-August-Universität Göttingen, Robert Koch Strasse 40, 3709 Göttingen, Germany.
authors.forename: Andre
authors.initials: A
authors.lastname: Puls
authors.forename: Beatrix
authors.initials: B
authors.lastname: Pollok-Kopp
authors.forename: Hermann
authors.initials: H
authors.lastname: Wrigge
authors.forename: Michael
authors.initials: M
authors.lastname: Quintel
authors.forename: Peter
authors.initials: P
authors.lastname: Neumann
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007378:Interleukins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000097:blood*; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D018709:Statistics, Nonparametric; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D018836:Inflammation Mediators; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha