title: Comparative analysis between the alveolar recruitment maneuver and breath stacking technique in patients with acute lung injury.
abstract: OBJECTIVE
  To compare the effectiveness of the alveolar recruitment maneuver and the breath stacking technique with respect to lung mechanics and gas exchange in patients with acute lung injury.
  
  
  METHODS
  Thirty patients were distributed into two groups: Group 1 - breath stacking; and Group 2 - alveolar recruitment maneuver. After undergoing conventional physical therapy, all patients received both treatments with an interval of 1 day between them. In the first group, the breath stacking technique was used initially, and subsequently, the alveolar recruitment maneuver was applied. Group 2 patients were initially subjected to alveolar recruitment, followed by the breath stacking technique. Measurements of lung compliance and airway resistance were evaluated before and after the use of both techniques. Gas analyses were collected before and after the techniques were used to evaluate oxygenation and gas exchange.
  
  
  RESULTS
  Both groups had a significant increase in static compliance after breath stacking (p=0.021) and alveolar recruitment (p=0.03), but with no significant differences between the groups (p=0.95). The dynamic compliance did not increase for the breath stacking (p=0.22) and alveolar recruitment (p=0.074) groups, with no significant difference between the groups (p=0.11). The airway resistance did not decrease for either groups, i.e., breath stacking (p=0.91) and alveolar recruitment (p=0.82), with no significant difference between the groups (p=0.39). The partial pressure of oxygen increased significantly after breath stacking (p=0.013) and alveolar recruitment (p=0.04), but there was no significant difference between the groups (p=0.073). The alveolar-arterial O2 difference decreased for both groups after the breath stacking (p=0.025) and alveolar recruitment (p=0.03) interventions, and there was no significant difference between the groups (p=0.81).
  
  
  CONCLUSIONS
  Our data suggest that the breath stacking and alveolar recruitment techniques are effective in improving the lung mechanics and gas exchange in patients with acute lung injury.
authors.affiliation: Curso de Graduação em Fisioterapia, Centro Universitário Adventista de São Paulo, São Paulo, SP, Brasil.
authors.forename: Elias Ferreira
authors.initials: EF
authors.lastname: Porto
authors.affiliation: Curso de Graduação em Fisioterapia, Centro Universitário Adventista de São Paulo, São Paulo, SP, Brasil.
authors.forename: Kelly Cristiani
authors.initials: KC
authors.lastname: Tavolaro
authors.affiliation: Curso de Graduação em Fisioterapia, Centro Universitário Adventista de São Paulo, São Paulo, SP, Brasil.
authors.forename: Claudia
authors.initials: C
authors.lastname: Kumpel
authors.affiliation: Curso de Graduação em Fisioterapia, Centro Universitário Adventista de São Paulo, São Paulo, SP, Brasil.
authors.forename: Fernanda Augusta
authors.initials: FA
authors.lastname: Oliveira
authors.affiliation: Curso de Graduação em Fisioterapia, Centro Universitário Adventista de São Paulo, São Paulo, SP, Brasil.
authors.forename: Juciaria Ferreira
authors.initials: JF
authors.lastname: Sousa
authors.affiliation: Curso de Graduação em Fisioterapia, Centro Universitário Adventista de São Paulo, São Paulo, SP, Brasil.
authors.forename: Graciele Vieira de
authors.initials: GV
authors.lastname: Carvalho
authors.affiliation: Curso de Graduação em Fisioterapia, Centro Universitário Adventista de São Paulo, São Paulo, SP, Brasil.
authors.forename: Antonio Adolfo Mattos de
authors.initials: AA
authors.lastname: Castro
mesh_terms: D055371:Acute Lung Injury / Q000628:therapy*; D000328:Adult; D000403:Airway Resistance / Q000502:physiology; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008170:Lung Compliance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D011650:Pulmonary Alveoli / Q000378:metabolism*; D011659:Pulmonary Gas Exchange / Q000502:physiology; D015656:Respiratory Mechanics / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D010100:Oxygen