Pulmonary atelectasis is a common complication after surgery that can result in an intrapulmonary shunt, refractory hypoxemia, and respiratory discomfort. Patients undergoing heart surgery may benefit from recruitment measures to alleviate pulmonary atelectasis. Researchers conducted a meta-analysis of randomized controlled studies to assess the effectiveness of recruitment tactics in these patients. Individual effect sizes were normalized, and a meta-analysis utilizing random-effects models was used to produce a pooled effect size. The presence of pulmonary atelectasis was determined by Researchers postoperatively. Hypoxic events, arterial oxygen tension (Pao2)/inspired oxygen fraction (Fio2) ratio, cardiac index, mean arterial pressure, and postoperative complications such as pneumothorax and pneumonia were among the secondary outcomes.
Researchers looked at 16 trials with 1455 subjects. Patients who received recruitment manoeuvres had a lower risk of pulmonary atelectasis (RR, 0.20; 95% confidence interval [CI], 0.07-0.57; RR, 0.54; 95% confidence interval [CI], 0.33-0.89), hypoxic events (RR, 0.23; 95% confidence interval [CI], 0.14-0.37), and pneumonia (RR, 0.23; 95% confidence interval [CI], 0.14-0.37), When compared to individuals who got standard mechanical ventilation, the Pao2/Fio2 ratio improved (WMD, 58.87, 95% CI, 31.24-86.50) without affecting the cardiac index (WMD, 0.22; 95% CI, –0.18 to 0.61) or mean arterial pressure (WMD, –0.30, 95% CI, –3.19 to 2.59). Pneumothorax was not significantly different across the groups. In patients following cardiac surgery, recruitment maneuvers may reduce postoperative pulmonary atelectasis, hypoxic episodes, and pneumonia and enhance Pao2/Fio2 ratios without causing the hemodynamic disturbance.
Reference:www.jtcvs.org/article/S0022-5223(20)33105-6/fulltext
