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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Recruitment manoeuvres in anaesthesia: How many more excuses are there not to us...
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Vol. 65. Issue 4.
Pages 209-217 (April 2018)
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Vol. 65. Issue 4.
Pages 209-217 (April 2018)
Review
Recruitment manoeuvres in anaesthesia: How many more excuses are there not to use them?
Maniobras de reclutamiento en anestesia: ¿qué más excusas para no usarlas?
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J. García-Fernándeza,b,
Corresponding author
, A. Romeroa, A. Blancoa, P. Gonzalezc, A. Abad-Gurumetad,e,f, S.D. Bergeseg
a Servicio de Anestesiología, Cuidados Críticos y Dolor, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
b Departamento de Cirugía, Facultad de Medicina, Universidad Autónoma, Madrid, Spain
c Department of Anesthesia and Perioperative Medicine, Akademiska University Hospital, Uppsala, Sweden
d Servicio de Anestesiología, Cuidados Críticos y Dolor, Hospital Universitario Infanta Leonor, Madrid, Spain
e La Revista Española de Anestesiología y Reanimación, Spain
f Departamento de Farmacología, Facultad de Medicina, Universidad Complutense, Madrid, Spain
g Neurosurgical Anesthesia, Departments of Anesthesiology and Neurological Surgery, The Ohio State University, Columbus, OH, United States
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Tables (3)
Table 1. Best indications for lung recruitment manoeuvres.
Table 2. Worst outcomes of recruitment manoeuvres.
Table 3. Contraindications for recruitment manoeuvres.
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Abstract

Pulmonary recruitment manoeuvres (RM) are intended to reopen collapsed lung areas. RMs are present in nature as a physiological mechanism to get a newborn to open their lungs for the first time at birth, and we also use them, in our usual anaesthesiological clinical practice, after induction or during general anaesthesia when a patient is desaturated. However, there is much confusion in clinical practice regarding their safety, the best way to perform them, when to do them, in which patients they are indicated, and in those where they are totally contraindicated. There are important differences between RM in the patient with adult respiratory distress syndrome, and in a healthy patient during general anaesthesia. Our intention is to review, from a clinical and practical point of view, the use of RM, specifically in anaesthesia.

Keywords:
Recruitment manoeuvres
Atelectasis
Mechanical ventilation
General anaesthesia
Protective ventilation
PEEP
Resumen

Las maniobras de reclutamiento (MR) pulmonar tienen como finalidad reabrir las áreas de pulmón colapsadas. Las MR están presentes en la naturaleza como un mecanismo fisiológico para conseguir que un neonato abra sus pulmones por primera vez al nacer, y también las usamos, en la práctica clínica anestesiológica habitual, en la inducción o durante la anestesia general al desaturar un paciente. Sin embargo, existe en la práctica clínica mucha confusión en cuanto a su seguridad, el mejor modo de realizarlas, cuándo llevarlas a cabo, en qué pacientes están indicadas y en quiénes están totalmente contraindicadas. Existen importantes diferencias entre la MR en el paciente con síndrome de distrés respiratorio del adulto y en paciente sano durante una anestesia general. Se pretende, desde un punto de vista clínico y práctico, revisar el empleo de la MR, específicamente en anestesia.

Palabras clave:
Maniobras de reclutamiento
Atelectasias
Ventilación mecánica
Anestesia general
Ventilación de protección
PEEP

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