C. Strategies of Maintaining Recruitment The application of positive end-expiratory pressure is known to prevent repetitive derecruitment-recruitment stresses on lung tissue. In an animal model of acute lung injury, Farias showed histologic and biochemical evidence of atelectotrauma is averted when PEEP is applied following lung recruitment7. The two principal strategies to prevent derecruitment following a recruitment maneuver include the open lung approach and decremental PEEP titration.