What is most attributed to effective alveolar recruitment?

Effective alveolar recruitment is primarily achieved by applying pressure above what is typically delivered during tidal volume breathing. This approach is often used in mechanical ventilation strategies, particularly in patients with atelectasis or low lung volumes. The rationale behind this is that by applying higher pressures, it can help to open collapsed or poorly ventilated alveoli, improving overall lung compliance and enhancing gas exchange.

When additional pressure is applied, it can create a recruitment maneuver that temporarily raises the end-expiratory lung volume, allowing for greater surface area for gas exchange. This technique promotes the recruitment of collapsed alveoli, thereby improving ventilation and oxygenation.

In contrast, varying peak pressures or using high peak flows may not specifically target alveolar recruitment but instead focus more on maintaining airway patency or achieving adequate ventilation without effectively addressing the underlying problem of collapsed alveoli. Additionally, disallowing the patient from exhaling completely could lead to complications such as hyperinflation, which does not directly facilitate effective recruitment of alveoli. Therefore, applying pressure above the normal tidal volume delivery is recognized as the most effective method for recruiting alveoli in clinical practice.