Open AccessA Novel Maneuver to Treat Refractory Atelectasis in Mechanically Ventilated Children
Author(s) -
Alejandro J. Martinez Herrada,
Michael Wien,
Steven Shein,
John Maher,
Janine Zee-Cheng,
Alexandre T. Rotta
Publication year - 2020
Publication title -
journal of pediatric intensive care
Language(s) - English
Resource type - Journals
eISSN - 2146-4618
pISSN - 2146-4626
DOI - 10.1055/s-0040-1721508
Subject(s) - medicine , atelectasis , refractory (planetary science) , mechanical ventilation , anesthesia , bronchoscopy , airway , surgery , lung , physics , astrobiology
We developed a novel airway clearance and lung recruitment maneuver for children with refractory unilateral atelectasis undergoing invasive mechanical ventilation. In this retrospective, single-center, proof of concept study, we describe the steps involved in this novel maneuver and evaluate its effectiveness in 15 patients through objective quantitation of changes in respiratory system compliance and in the degree of atelectasis assessed by a validated Modified Radiology Atelectasis Score. Compared with the premaneuver baseline, the median atelectasis score improved significantly following the maneuver (9 [7.5-10] vs. 1 [0-3.3], respectively, p < 0.01). Likewise, dynamic compliance was significantly higher following the maneuver (0.3 [0.32-0.44] vs. 0.61 [0.53-0.69] mL/kg/cm H 2 O, respectively, p < 0.01). No patients required a bronchoscopy. This simple and effective maneuver resulted in a significant improvement in the degree of atelectasis and dynamic compliance in this cohort of mechanically ventilated children with refractory unilateral atelectasis.