Efficacy of alveolar recruitment maneuvers in patients with complicated thoracic trauma.

The objective of this study was to measure the efficacy of biphasic positive airway pressure (BIPAP) and synchronized intermittent mandatory ventilation (SIMV) with alveolar recruitment maneuvers (ARMs) in patients with acute lung injury (ALI) and concomitant pneumothorax. Seventy-four patients with ALI and concomitant pneumothorax secondary to blunt thoracic injury were studied. All patients fulfilled criteria for the first stage of acute respiratory distress syndrome, which consisted of acute onset dyspnea, isolated rales, an extravascular lung water index >7 mL/kg, and an oxygenation index <300 mm Hg in the absence of left-ventricular dysfunction.