Alveolar recruitment maneuver in anesthetic practice: how, when and why it may be useful.
OBJECTIVE
Alveolar recruitment maneuver (ARM) is the reopening of lung tissue collapsed by increased airway inspiratory pressure, primarily performed in patients with acute respiratory distress syndrome. This study aimed at evaluating ARM in anesthesia, how to do it and in which clinical situations.


METHODS
Literature review using MedLine database in the period 1993 to 2004.


RESULTS
Most common approach for recruitment maneuver is sustained inflation by CPAP with pressures varying from 30 to 40 cmH2O for 30 to 90 seconds. ARM was beneficial during laparoscopic procedures, single-lung ventilation surgeries and cardiac surgeries, and for obese and pediatric patients.


CONCLUSIONS
Recruitment maneuver may be useful for anesthetic practice, improving postoperative oxygenation and re-expanding atelectasis of anesthetized patients.
Gonçalves
Luciana Oliveira
LO
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP.
Cicarelli
Domingos Dias
DD