Lung volume recruitment maneuvers and respiratory system mechanics in mechanically ventilated mice

Abstract The study aim was to establish how recruitment maneuvers (RMs) influence lung mechanics and to determine whether RMs produce lung injury. Healthy BALB/c mice were allocated to receive positive end-expiratory pressure (PEEP) at 2 or 6 cmH2O and volume- (20 or 40 mL/kg) or pressure-controlled (25 cmH2O) RMs every 5 or 75 min for 150 min. The low-frequency forced oscillation technique was used to measure respiratory input impedance. Large RMs resulting in peak airway opening pressures (Pao) > 30 cmH2O did not increase inflammatory response or affect transcutaneous oxygen saturation but significantly lowered airway resistance, tissue damping and tissue elastance; the latter changes are likely associated with the bimodal pressure–volume behavior observed in mice. PEEP increase alone and application of RMs producing peak Pao below 25 cmH2O did not prevent or reverse changes in lung mechanics; whereas frequent application of substantial RMs on top of elevated PEEP levels produced stable lung mechanics without signs of lung injury. Keywords Pulmonary elastance; Airway resistance; Lung volume history; Recruitment maneuver; Mechanical ventilation