title: Effectiveness of end-expiratory lung volume measurements during the lung recruitment maneuver for patients with atelectasis.
abstract: OBJECTIVE
  The aim of this study was to determine whether the relative change in the end-expiratory lung volume (EELV) obtained by the recruitment maneuver (RM) can serve as an indicator of the change in the P/F ratio.
  
  
  METHODS
  The effects of the intermittent stepwise increases in the RM (peak inspiratory pressure, 45, 50, and 55 cm H2O) were compared in 21 patients with atelectasis under mechanical ventilation. The EELV, the ratio of arterial oxygen concentration to the fraction of inspired oxygen P/F ratio, and relative change rate (Δ) in these parameters were evaluated after each RM.
  
  
  RESULTS
  A greater improvement in the EELV (1157 ± 344 mL vs 1469 ± 396 mL) and P/F ratio (250 ± 99 vs 320 ± 92) was observed after the RM. The ΔEELV was correlated with the ΔP/F ratio (ρ = 0.73, P < .01) and was identified as an accurate predictor of the improvement of the ΔP/F ratio by the receiver operating characteristic curve (the area under the curve, 0.93; P < .01).
  
  
  CONCLUSIONS
  These results suggest that the ΔEELV obtained by intermittent stepwise RM can serve as an indicator of the change in the P/F ratio.
authors: Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, N15W7 Kita-ku, Sapporo 060-8638, Japan. n14w4@s3.dion.ne.jp
authors: Susumu
authors: S
authors: Nakahashi
authors: Satoshi
authors: S
authors: Gando
authors: Takehiko
authors: T
authors: Ishikawa
authors: Takeshi
authors: T
authors: Wada
authors: Yuichiro
authors: Y
authors: Yanagida
authors: Nobuhiko
authors: N
authors: Kubota
authors: Shinji
authors: S
authors: Uegaki
authors: Mineji
authors: M
authors: Hayakawa
authors: Atsushi
authors: A
authors: Sawamura
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D005260:Female; D005652:Functional Residual Capacity; D006801:Humans; D008170:Lung Compliance; D008176:Lung Volume Measurements; D008297:Male; D010100:Oxygen / Q000097:blood; D018579:Patient Selection; D001261:Pulmonary Atelectasis / Q000503:physiopathology* / Q000628:therapy*; D012372:ROC Curve; D012121:Respiration, Artificial; D015656:Respiratory Mechanics
chemical_list: D010100:Oxygen
keywords: Atelectasis; End-expiratory lung volume; Functional residual capacity; Recruitement maneuver; Respiratory therapy