{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:02:51Z","timestamp":1782842571569,"version":"3.54.5"},"reference-count":40,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Obesity may increase the risk of respiratory failure after cardiothoracic surgery. A recruitment maneuver followed by PEEP might decrease the risk of respiratory failure in obese subjects. We hypothesized that the routine use after heart surgery of a recruitment maneuver followed by high or low PEEP level would decrease the frequency of respiratory failure in obese subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      In a pragmatic, randomized controlled trial, we assigned obese subjects (ie, with body mass index [BMI]\n                      <jats:bold>\u2265<\/jats:bold>\n                      30 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) in the immediate postoperative period of cardiothoracic surgery to either volume control ventilation with 5 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O of PEEP (control group) or a recruitment maneuver followed by 5 or 10 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O of PEEP in the intervention arms (RM5 and RM10 groups, respectively). The primary outcome was the proportion of subjects with postextubation respiratory failure, defined as the need for re-intubation, bi-level positive airway pressure, or high-flow nasal cannula within the first 48 h.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The study included 192 subjects: 65 in the control group (BMI 33.5 \u00b1 3.2 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), 66 in the RM5 group (BMI 34.5 \u00b1 3.2 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , and 61 in RM10 group (BMI 33.8 \u00b1 4.8 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Postextubation respiratory failure occurred in 14 subjects in the control group (21.5% [95% CI 13.3\u201335.3]), 21 subjects in the RM5 group (31.8% [95% CI 21.2\u201344.6]), and 9 subjects in the RM10 group (14.7% [95% CI 7.4\u201326.7]) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .07). The recruitment maneuver was stopped prematurely due to severe hypotension in 8 (12.1%) RM5 subjects and in 4 (6.6%) RM10 subjects (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .28). There were no significant differences between the 3 groups for the frequencies of atelectasis, pneumonia, and death in the ICU.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      The routine use after heart surgery of a recruitment maneuver followed by 5 or 10 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O of PEEP did not decrease the frequency of respiratory failure in obese subjects. A recruitment maneuver followed by 5 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O of PEEP is inappropriate.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.08607","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T14:50:37Z","timestamp":1620744637000},"page":"1306-1314","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Recruitment Maneuvers and PEEP on Respiratory Failure , After Cardiothoracic Surgery in Obese Subjects: A Randomized Controlled Trial"],"prefix":"10.1177","volume":"66","author":[{"given":"Priscilla","family":"Amaru","sequence":"first","affiliation":[{"name":"Cardiothoracic ICU, Department of Anesthesiology and ICU, H\u00f4pital Marie Lannelongue, Le Plessis Robinson, 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France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saida","family":"Rezaiguia-Delclaux","sequence":"additional","affiliation":[{"name":"Anesthesiology, Clinique de la Sauvegarde, Lyon, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"St\u00e9phan","sequence":"additional","affiliation":[{"name":"Cardiothoracic ICU, Department of Anesthesiology and ICU, H\u00f4pital Marie Lannelongue, Le Plessis Robinson, 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