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Department of Anesthesia, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada, jlohser{at}yahoo.ca
To the Editor:
The study by Hansen et al. (1) showed that a targeted lobar recruitment maneuver is equally effective as whole lung recruitment, but free of the circulatory compromise that is commonly encountered with the latter. Cardiac surgery may not be the best example to illustrate the importance of a targeted lobar recruitment maneuver, as lung collapse after bypass procedures tends to be generalized. In thoracic surgery, dense atelectasis primarily affects lobes in the operative hemithorax. Because we restrict fluid administration during thoracic surgery, whole lung recruitment tends to cause hypotension. Consistent with the findings of Hansen et al., it is appropriate to clamp the nonoperative lumen of the double-lumen endobronchial tube during the vital capacity maneuver after thoracic surgery to minimize the hypotensive response.
REFERENCE
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