Effect of Intensive vs Moderate Alveolar Recruitment Strategies Added to Lung Protective Ventilation on PP Complications

Abstract

Aim: to establish the effects of intensive alveolar recruitment therapy in decreasing the post-operative pulmonary complications. Methodology: A randomized multi centered study was performed with patients in ICU having hypoxemia after a cardiac surgery. Patients were allocated to two groups (intensive vs moderate recruitment strategy) with ventilation having small tidal volume. Severity of post-operative pulmonary complications was primary outcome. Secondary outcome was duration of stay in hospital and ICU, hospital mortality and the rate of barotrauma. Results: The pulmonary complication severity score of the intensive and moderate group patients was 1.58±0.91 and 2.10±1.01 respectively. The mean ICU stay, hospital stay and mechanical ventilation in ICU mean of the intensive group patients was 4.06±2.12 days, 10.10±3.21 days and 11.26±2.80 respectively. While, the mean ICU stay, hospital stay and mechanical ventilation in ICU mean of the moderate group patients was 4.70±2.04 days, 14.09±2.99 days and 12.15±2.08 respectively. Conclusion: Patients having hypoxemia after a cardiac surgery, intensive alveolar recruitment therapy proves to be more helpful in decreasing the severity and occurrence of post-operative pulmonary complications as compared to moderate alveolar recruitment therapy. Keywords: Alveolar recruitment, tidal volume, pulmonary complications.