Volume 69 Numbers 1 & 2 January/March 2002	back to contents

The Open Lung Concept of Alveolar Recruitment Can Improve Outcome in Respiratory Failure and ARDS	73-77
Peter J. Papadakos, M.D.1, and Burkhard Lachmann, M.D., Ph.D.2

¹Associate Professor, Anesthesiology and Surgery, Departments of Anesthesiology and Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY and ²Professor of Anesthesiology, Department of Anesthesiology, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands.

Address correspondence to Peter J. Papadakos, M.D., F.C.C.M., F.C.C.P., Director, Division of Critical Care Medicine, University of Rochester, Box 604, 601 Elmwood Avenue, Rochester, NY 14642.

ABSTRACT

Respiratory failure is a common finding in the ICU and in the management of complex cases in the operating room. Over the last ten years, it has become clear that modes of mechanical ventilation and lung recruitment may play a role both in cytokine modulation and patient outcome.

Early lung recruitment and alveolar stabilization may play a very important role in the management of patients with respiratory failure and adult respiratory distress syndrome (ARDS). The open lung concept may be the key to decreasing mortality and morbidity in these patients. This technique not only improves oxygenation, but also affects surfactant function and cytokine modulation.

The open lung concept is physiologically based on the Law of Laplace. Adhering to the principles of the open lung concept, pressure-controlled ventilation may improve patient outcome by reducing the extent of irreversible structural damage to the lungs caused by mechanical ventilation.

KEYWORDS

ARDS, alveolar recruitment, open lung concept, respiratory failure.

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