Effects of a single-lung recruitment maneuver on the systemic release of inflammatory mediators.
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.
Puls
Andre
A
Zentrum Anaesthesie, Rettungs- und Intensivmedizin, Georg-August-Universität Göttingen, Robert Koch Strasse 40, 3709 Göttingen, Germany.
Pollok-Kopp
Beatrix
B
Wrigge
Hermann
H
Quintel
Michael
M
Neumann
Peter
P
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*
D018836:Inflammation Mediators; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha