Preconditioning lung collapse: effects of early recruitment maneuvers on lung deflation dynamics during one-lung ventilation.

Background: Rapid and adequate lung collapse is essential for optimal surgical exposure during video-assisted thoracoscopic surgery (VATS). Although recruitment maneuvers (RMs) are widely used to improve alveolar aeration, whether their application immediately after tracheal intubation facilitates lung collapse during one-lung ventilation remains uncertain. This randomized controlled trial evaluated the effects of immediate post-intubation RMs on lung collapse dynamics, perioperative oxygenation, and postoperative pulmonary complications. Methods: Sixty adult patients undergoing elective VATS were randomized to a recruitment maneuver group (RM, Results: Compared with standardized ventilatory strategy, immediate post-intubation RMs significantly shortened the time to complete lung collapse (14.4 ± 3.3 min vs. 16.9 ± 3.7 min, Conclusion: Recruitment maneuvers performed immediately after intubation were associated with accelerated lung collapse and improved early lung collapse quality. These findings support a potential role for early recruitment maneuvers in optimizing early surgical exposure during one-lung ventilation. Clinical trial registration: https://www.chictr.org.cn/, ChiCTR2300075148.