Table 1 Recruitment and lung re-expansion maneuver steps

Recruitment maneuver

1. Increase F_IO₂ to 1.0

2. Set peak inspiratory pressure limit to 45 cmH₂O

3. Set respiratory rate to six breaths/min

4. Set I:E ratio to 1:1

5. Increase VT in steps of approximately 2 mL/kg PBW until plateau pressure reaches 30–40 cmH₂O

6. If the maximum VT allowed by the anesthesia ventilator is achieved and the plateau pressure is lower than 30 cmH₂O, increase the PEEP as needed, to a maximum of 20 cmH₂O

7. Allow three breaths while maintaining plateau pressure of 30–40 cmH₂O

8. Set VT, PEEP, respiratory rate, and I:E ratio back to pre-recruitment values

Lung re-expansion maneuver

1. Keep the non-ventilated under visual inspection, whenever possible

2. Connect the CPAP device with adequate oxygen flow (F_IO₂ 1.0) to the non-ventilated lung

3. Set CPAP to 10 cmH₂O during 20 s

4. Set CPAP to 15 cmH₂O during 20 s

5. Set CPAP to 20 cmH₂O during 20 s

6. If performed as part of a rescue therapy for hypoxemia and oxygenation has been restored, reduce CPAP as soon as possible to 10 cmH₂O, or 5 cmH₂O, or disconnect the CPAP device