Alveolar recruitment maneuver in refractory hypoxemia and lobar atelectasis after cardiac surgery: a case report.
OBJECTIVE
This case report describes an unusual presentation of right upper lobe atelectasis associated with refractory hypoxemia to conventional alveolar recruitment maneuvers in a patient soon after coronary artery bypass grafting surgery.


METHODS
Case-report.


RESULTS
The alveolar recruitment with PEEP = 40 cm H2O improved the patient's atelectasis and hypoxemia.


CONCLUSIONS
In the present report, the unusual alveolar recruitment maneuver with PEEP 40 cm H2O showed to be safe and efficient to reverse refractory hypoxemia and uncommon atelectasis in a patient after cardiac surgery.
Physiotherapy Department, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. marcus@fisiorespiratoria.com.br
Marcus Vinicius
MV
Herbst-Rodrigues
Vitor Oliveira
VO
Carvalho
Ludhmila Hajjar
LH
Abrahao
Emilia
E
Nozawa
Maria Ignez Zanetti
MI
Feltrim
Filomena Regina Barbosa
FR
Gomes-Galas
D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods*; D011183:Postoperative Complications / Q000628:therapy*; D001261:Pulmonary Atelectasis / Q000209:etiology / Q000628:therapy*; D013510:Pulmonary Surgical Procedures / Q000379:methods*; D013902:Radiography, Thoracic