Hemodynamic effects of lung recruitment maneuvers in critically ill patients

Atelectasis leads to increased intrapulmonary shunt, venous admixture and hypoxaemia. Lung recruitment maneuvers aim to quickly reverse this scenario by applying increased airway pressures for a short period of time, which means to open the collapsed alveoli. Although the procedure can improve oxygenation, elevated intrathoracic pressures can inflict serious effects on the cardiovascular system due to the heart-lung and right and left ventricle interactions. The purpose of this article is to give an overview on the pathophysiological background of the heart-lung interactions and the best way to monitor these changes during lung recruitment.