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BJA Advance Access originally published online on December 16, 2005
British Journal of Anaesthesia 2006 96(2):156-166; doi:10.1093/bja/aei299
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

REVIEW ARTICLE

Alveolar recruitment in acute lung injury

G. Mols*, H.-J. Priebe and J. Guttmann

Department of Anaesthesia and Critical Care Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany

* Corresponding author. E-mail: Georg.Mols{at}uniklinik-freiburg.de

Alveolar recruitment is one of the primary goals of respiratory care for acute lung injury. It is aimed at improving pulmonary gas exchange and, even more important, at protecting the lungs from ventilator-induced trauma. This review addresses the concept of alveolar recruitment for lung protection in acute lung injury. It provides reasons for why atelectasis and atelectrauma should be avoided; it analyses current and future approaches on how to achieve and preserve alveolar recruitment; and it discusses the possibilities of detecting alveolar recruitment and derecruitment. The latter is of particular clinical relevance because interventions aimed at lung recruitment are often undertaken without simultaneous verification of their effectiveness.


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