[Effects of recruitment maneuver on elderly patients after major operations]

To study the effect of recruitment maneuver (RM) in preventing atelectasis and lung injury in elderly patients after major operations, and to evaluate the safety of RMs.

Forty elderly patients after major operations were admitted to intensive care unit (ICU) of Beijing Air Force General Hospital from February 2007 to February 2008 were randomized into RM group and control group. The patients were still under the effect of anesthesia and muscle relaxation when admitted. All of them were under invasive blood pressure monitoring, which was continued for over 6 hours. RM was conducted by regulating inspired oxygen concentration (FiO2) to 0.60, respiratory rate 20/min, tidal volume (VT) 5 ml/kg, with 25 cm H2O (1 cm H2O=0.098 kPa) of continuous positive end-expiratory pressure (PEEP) for 30 seconds, and then the previous ventilator setting was resumed. The above modality was repeated once after 1 hour. Heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), platform airway pressure (Pplat), percutaneous oxygen saturation (SpO2) were measured before and after the RM. Arterial blood gas analysis was done before and after RMs. The presence of pulmonary atelectasis or pulmonary infection was looked for after RMs.

(1) There were significant changes in HR, CVP and MAP during RM (all P<0.05), circulation function was not affected. (2) There were no significant changes in HR, MAP, CVP and SpO2 before and after RMs (all P>0.05). Pplat was significantly reduced after RMs (P<0.05). (3) The incidence of pulmonary atelectasis or pulmonary infection was significantly lower in RM group (both P<0.05). (4) Oxygenation index (PaO2/FiO2) in RM group was significant increased (P<0.05) .

RM is safe when used in elderly patients. It can significantly improve oxygenation in elderly patients.