How to use the Automatic Stepwise Recruitment Maneuver (Auto SRM), on the Getinge Servo-u ventilator

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Dr. Fernando Suárez-Sipmann, MD-PhD, Intensive Care Specialist at the La Princesa University Hospital, Madrid, Spain, shares his clinical impressions of the new Automatic Stepwise Recruitment Maneuver (Auto SRM) and how to use the Open Lung Approach (OLA) on the Servo-u mechanical ventilator, as part of its innovative Open Lung Tool.
Lung recruitment maneuvers are transient increases in transpulmonary pressure used to open up collapsed alveoli, improve respiratory system compliance, end-expiratory lung volume and alveolar gas exchange, used in patient groups with impaired lung function such acute respiratory distress syndrome (ARDS) and morbid obesity.
The role of lung recruitment maneuvers and how to best set PEEP is still debated, where OLA is a lung protective-approach that describes determination of optimal PEEP through a decremental PEEP titration followed by a re-recruitment, in order to reduce the airway driving pressure and to prevent cyclic alveolar collapse. Within this personalized approach to lung-protection, lung recruitability can be assessed and potential harm for ventilation-induced lung injury (VILI) can thus be prevented in patients (“non-responders”) that are not likely to benefit from the recruitment maneuver and higher PEEP levels.
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