Effect Alveolar Recruitment Manoeuver on Stroke Volume a Randomized Study

Hemodynamic Effect of Alveolar Recruitment Manoeuver Through Stepwise Increase and Decrease in Irway Pressure or Sustained 30 Secondes 30 cmH2O Continuous Positive Airway Pressure. A Randomized Study.

Objective: to compare the effect of alveolar recruitment manouver through stepwise increase and decrease in airway pressure or sustained 30 secondes 30 cmH2O continuous positive airway pressure on cardiac stroke volume estimated by oesophageal doppler in preload independent anesthetized patients scheduled for surgery.

Following anesthesia and preload optimisation guided by cardiac stroke volume, patients will be randomised to one alveolr recruitment manoeuver :

• stepwise increase and decrease in positive airway pressure
• sustained 30 secondes 30 cmH2O continuous positive airway pressure The primary objective is the change in cardiac stroke volume.

Inclusion Criteria:

• adult patients scheduled for major surgery requiring hemodynamic monitoring
• written signed informed consent

Exclusion Criteria:

• pregnancy
• non sinusal heart rate
• known cardiac right ventricular failure or arterial pulmonary hypertension
• pneumothorax
• known pulmonary emphysema