Respiratory Mechanics: Revisiting the Appraisement of Lung Recruitment

Abstract

Mechanical ventilation has long been recognized as the most vital therapy for patients with ARDS. Compared with lung-protective ventilation, debates that involve the open lung strategy, which consists primarily of the lung recruitment maneuver and higher PEEP, have never been resolved. In terms of the beneficial and detrimental effects of this aggressive maneuver, appraisal of lung recruitment is essential for intensivists to make clinical decisions. This review aimed to clarify how to assess the potential for lung recruitment based on respiratory mechanics when using the pressure-volume curve or loop method and end-expiratory lung volume–static compliance of the respiratory system method. However, their limitations related to excessive generalization, accuracy, and identification of cutoff values cannot be omitted. Finally, future studies are warranted to combine these classic methods with newly invented techniques to achieve safer and more effective lung recruitment.