TY - JOUR T1 - Assessment of lung recruitment with continuous negative extrathoracic pressure after one-lung ventilation: an experimental investigation JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2022.1663 VL - 60 IS - suppl 66 SP - 1663 AU - Á Schranc AU - J Diaper AU - R Südy AU - F Peták AU - W Habre AU - G Albu Y1 - 2022/09/04 UR - http://erj.ersjournals.com/content/60/suppl_66/1663.abstract N2 - Background: Lung recruitment manoeuvres following one-lung ventilation (OLV) have the potential to induce lung injury. Application of continuous negative extrathoracic pressure ventilation (CNEP) for lung recruitment has yet to be explored. We investigated the effects of CNEP following OLV on lung expansion, gas exchange, and haemodynamics.Methods: An endotracheal blocker was inserted in 10 anesthetized pigs (45±0.5 kg) and OLV was ensured with pressure-regulated volume control mode (PRVC) (FiO2: 0.5, respiratory rate: 30-35/min, tidal volume (VT): 5 ml/kg, positive end-expiratory pressure: 5 cmH2O). Electrical impedance tomography, blood gas, cardiac output (CO) and extravascular lung water (EVLW) were measured after 1 hour of OLV. Double-lung ventilation was then started, combining PRVC (VT: 7 ml/kg) and CNEP (-15 cmH2O) without active recruitment of the collapsed lung beforehand and measurements were repeated at 5 minutes and 1 hour.Results: Five minutes following initiation of CNEP oxygenation and CO2 elimination improved (154.1±13.3 vs 173.8±22.1 mmHg and 52.6±11.7 vs 40.3±4.5 mmHg, p<0.05 respectively) and lung aeration increased in the non-collapsed lung (p<0.05). After an hour of CNEP, no additional improvement in gas exchange was noted despite increase in aeration of the collapsed lung (p<0.05). CO and EVLW remained stable under CNEP.Conclusions: Application of CNEP in the presence of whole lung atelectasis proved to be efficient in recruiting the lung without inducing lung oedema. Combining CNEP to positive pressure ventilation may offer beneficial effects at reducing atelectasis following lung collapse during thoracic procedures.FootnotesCite this article as Eur Respir J 2022; 60: Suppl. 66, 1663.This article was presented at the 2022 ERS International Congress, in session “-”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -