Bedside Assessment of Lung Recruitability: Making Sense of the Recruitment-to-Inflation Ratio

Abstract

Determination of optimum PEEP levels remains an elusive goal. One factor is the recruitability of the lung, yet this is another difficult determination. Recently, a simple bedside technique, called the recruitment-to-inflation ratio, has been described and validated by comparison to the dual pressure-volume curve method. We describe the prior research and concepts of lung mechanics leading up to this metric and develop some background mathematics that help clinicians understand its meaning.

Keywords: P-V curve; compliance; mechanical ventilation; optimal PEEP; pressure-volume curve; recruitability; recruitment maneuver.