A recruitment manoeuvre performed after endotracheal suction does not increase dynamic compliance in ventilated paediatric patients: a randomised controlled trial.

Morrow B, Futter M, Argent A

Research Question: Does a recruitment manoeuvre after suctioning have any immediate or short term effect on ventilation and gas exchange in mechanically-ventilated paediatric patients?

Participants: 48 paediatric patients with heterogeneous lung pathology.

Intervention: The experiment group received a single standardised suctioning procedure followed five minutes later by a standardised recruitment manoeuvre. The control group received only the single suctioning procedure.

Outcome measures: Measures of ventilation and gas exchange were recorded on three occasions before and on two occasions after the recruitment manoeuvre, using a respiratory profile monitor.

Results: There was no difference between the experimental and control group in dynamic compliance, expired airway resistance or oxygen saturation either immediately after the recruitment manoeuvre or after 25 minutes. The experimental group decreased mechanical expired tidal volume by 0.3 ml/kg, increased spontaneous expired tidal volume by 0.3 ml/kg and increased total respiratory rate by 3 bpm immediately after the recruitment manoeuvre, compared with the control group.

Conclusion: There is insufficient evidence to support performing recruitment manoeuvres after suctioning infants and children.

Australian Journal of Physiotherapy. 2007,53(3):163-9

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