Comparison of the tidal volume by the recruitment maneuver combined with positive end-expiratory pressure for mechanically ventilated children

Abstract

The recruitment maneuver (RM) combined with PEEP to prevent atelectasis have beneficial effects. However, the change in tidal volume (V_T) due to RM combined with PEEP in pediatric patients during the induction of general anesthesia is unknown. Therefore, we assessed the effects of RM combined with PEEP on V_T. Pediatric patients were divided into three groups: infants, preschool children, and school children. The RM was performed by maintaining pressure control continuous mandatory ventilation (PC-CMV) with a 15 cmH₂O and PEEP increase of 5 cmH₂O. V_T, respiratory function and hemodynamics were monitored before and after RM combined with PEEP. V_T (mL) /ideal body weight (kg) before vs. after RM combined with PEEP were 9 vs 12 mL/kg (p < 0.05) in the infants, 9 vs 11 mL/kg (p < 0.05) in the preschool children, 8 vs 10 mL/kg (p < 0.05) in the school children, respectively. HR and BP before and after RM combined with PEEP increased by 2-3% and decreased by 4-7% in all groups. RM combined with PEEP resulted in an increase in V_T per ideal body weight (1.1-1.2%). Therefore, this RM combined with PEEP method might improve the lung function in pediatric patients.