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LETTER TO THE EDITOR

One-Lung Ventilation Calls for One-Lung Recruitment

Department of Anesthesiology and Intensive Care, Aalborg Hospital–Århus University Hospitals, Aalborg, North Jutland, Denmark, an.larsson{at}nja.dk

In Response:

We agree with Dr. Lohser (1) that in the case of single-lung collapse, from a hemodynamic standpoint it is better to perform the one-lung recruitment maneuver than the global-recruitment maneuver (2). As pointed out by Dr. Lohser, lung collapse is found in the dorsal, basal parts of both lungs after cardiac surgery, although the left lower lobe is usually more compromised. In a previous study (3), we found that the majority of patients had partial or total left, lower-lung collapse the day after coronary artery bypass surgery. This finding agrees well with results by other investigators (3–5). Therefore, we still believe that a selective recruitment maneuver is clinically useful, although whether the maneuver is effective or decreases morbidity needs to be studied.

REFERENCES

1. Lohser J. One-lung ventilation calls for one-lung recruitment. Anesth Analg 2007;104:220.[Free Full Text]
2. Hansen LK, Sloth E, Nielsen J, et al. Selective recruitment maneuvers for lobar atelectasis: effects on lung function and central hemodynamics—an experimental study in pigs. Anesth Analg 2006;102:1504–10.[Abstract/Free Full Text]
3. Dyhr T, Laursen N, Larsson A. Effects on lung recruitment maneuver and positive end-expiratory pressure on lung volume, respiratory mechanics and alveolar gas mixing in patients ventilated after cardiac surgery. Acta Anaesthesiol Scand 2002;46: 717–25.[Web of Science][Medline]
4. Tenling A, Hachenberg T, Tyden H, et al. Atelectasis and gas exchange after cardiac surgery. Anesthesiology 1998;89:371–8.[Web of Science][Medline]
5. Narayan P, Caputo M, Jones J, et al. Postoperative chest radiographic changes on-and after off-pump surgery. Clin Radiol 2005;60:693–9.[Web of Science][Medline]

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