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Regional Ventilation Delay Index: Detection of Tidal Recruitment using Electrical Impedance Tomography

  • T. Muders
  • H. Luepschen
  • C. Putensen

Abstract

Apart from restoring adequate gas exchange, mechanical ventilation should avoid factors known to further aggravate lung injury such as inspiratory overdistension as well as cyclic opening and closing (tidal recruitment) of ventilatory units during tidal ventilation. Both are considered as major risk factors in the pathogenesis of ventilation-associated lung injury (VALI) [1, 2, 3]. The risk of inspiratory overdistension can be reduced by using small tidal volumes and by limiting inspiratory plateau pressures [4]. Low tidal volume ventilation, however, is known to promote end-expiratory alveolar collapse [5, 6], thus, potential for alveolar recruitment and risk for cyclic opening and closing of ventilatory units (tidal recruitment) is increased. To avoid end-expiratory alveolar collapse, an adequate positive end-expiratory pressure (PEEP) is needed [7, 8]. Although experimental investigations have shown that elevated PEEP levels protect from VALI [9, 10], studies comparing high-PEEP and low-PEEP strategies have failed so far to show a consistent improvement in mortality [11, 12, 13].

Keywords

Acute Lung Injury Acute Respiratory Distress Syndrome Electrical Impedance Tomography Recruitment Maneuver Lung Recruitment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • T. Muders
    • 1
  • H. Luepschen
    • 1
  • C. Putensen
    • 1
  1. 1.Department of Anesthesiology and Intensive CareUniversity of BonnBonnGermany

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