Post-suction recruitment manoeuvre restores lung function in healthy, anaesthetized pigs

Endotracheal suction can cause partial lung collapse and hypoxia and alter lung mechanics. We investigated the effects of adding a recruitment manoeuvre directly after endotracheal suction to restore lung volume in volume-controlled ventilation and pressure-controlled ventilation modes. Five anaesthetized pigs were investigated. The effects of endotracheal suction with or without a recruitment manoeuvre were compared in random order In volume-controlled ventilation, compliance decreased after suction from 33 5 to 26 6 ml.cmH(2)O(-1) (P<0.05), and 30 minutes later it remained decreased at 25+/-6 ml.cmH(2)O(-1). Venous admixture increased after suction from 5+/-2 to 8+/-4% (P<0.05), but had recovered at 30 minutes. In pressure-controlled ventilation, compliance decreased after suction from 34+/-3 to 25+/-7 ml.cmH(2)O(-1) (P<0.05), and 30 minutes later it remained decreased at 25+/-7ml.cmH(2)O(-1). Venous admixture increased after suction from 5+/-2 to 13+/-7% (P<0.05), and had not recovered after 30 minutes, 10+/-4%. When a recruitment manoeuvre was applied directly after suction, no negative side-effects were registered in volume-controlled ventilation or pressure-controlled ventilation. We conclude that the impairment of lung mechanics and gas exchange induced by endotracheal suction can be prevented by a simple post-suction recruitment manoeuvre. Further studies are needed to identify a suitable suction recruitment manoeuvre in patients with diseased lungs.