Blowing up diseased lungs could save lives

Patients with acute respiratory distress syndrome (ARDS) rely on mechanical ventilation to breathe, however routine suctioning to remove debris that may be blocking their airways can cause lung tissue to collapse. New research published in Critical Care explains how a new technique involving the re-inflation of lungs after suctioning can lead to a marked improvement in the condition of patients with acute respiratory distress syndrome.

Acute respiratory distress syndrome is a devastating inflammatory lung disease that affects around 150,000 people each year in the US alone. The syndrome is characterized by fluid accumulation and swelling in the lungs, followed by respiratory failure that can often be fatal.

An ARDS patient relies on mechanical ventilation to breathe, but if their airway becomes fully or even partially blocked it can lead to several serious physiological abnormalities and even death. Unfortunately, the use of suctioning to remove obstruction can lead to the collapse of lung tissues making it more difficult for a patient to get oxygen into their bodies.

In an effort to improve the care of patients with ARDS, Thomas Dyhr and colleagues have investigated the effect of re-inflating the lungs after suctioning. This re-inflation technique is known as a lung recruitment manoeuvre as it “recruits” previously collapsed lung tissue to help the patient breathe more easily

Dyhr and colleagues conducted a small randomised controlled study of eight patients with ARDS to test whether inflating the lung twice after suctioning was beneficial. The lung volume and the concentration of oxygen in arterial blood was monitored to establish the effects of the treatment.

The results showed that re-inflation was able to reduce the adverse effects of suctioning by increasing both the lung volume and the level of oxygen in arterial blood.

The researchers recognise this is only a small preliminary study, but they are hopeful that this re-inflation technique could have a positive impact on the recovery of patients with ARDS.

This research article is freely available online at http://ccforum.com/inpress/cc1844 and is scheduled to be in Critical Care’s next print issue.