Respiratory failure & ventilation
Recruitment-to-inflation Ratio Assessed through Sequential End-expiratory Lung Volume Measurement in Acute Respiratory Distress Syndrome
Authors' conclusion
Both global and granular recruitment-to-inflation ratio accurately estimate PEEP-induced changes in lung dynamic strain. However, the effect of 10 cm H2O of PEEP on lung strain may be nonuniform.
Study context
- Population
- Patients with moderate-to-severe COVID-19 ARDS
- Participants
- 20 patients
- Comparison
- Global vs granular recruitment-to-inflation ratio
- Outcome
- Recruitment-to-inflation ratio and its correlation with PEEP-induced change in dynamic strain
Methodological detailsdecremental positive end-expiratory pressure (PEEP) trial, nitrogen dilution end-expiratory lung volume measurement
- Decremental PEEP trial
- Nitrogen dilution end-expiratory lung volume measurement
Main finding
As reported in the abstract
- Global recruitment-to-inflation ratio (15 to 5 cm H2O), median [IQR]
- 1.27 [0.40 to 1.69]
- Correlation of global ratio with PEEP-induced dynamic strain reduction (r)
- r = −0.94; P < 0.001
- Intraindividual ratio variability within narrower ranges
- 85% [70 to 109]
- Granular ratio vs PEEP: nonlinear, quadratic relationship (R2)
- R2 = 0.96
- Correlation of granular ratio with PEEP-induced dynamic strain reduction (r)
- r = −0.89; P < 0.001
Original publication
Recruitment-to-inflation Ratio Assessed through Sequential End-expiratory Lung Volume Measurement in Acute Respiratory Distress Syndrome. Anesthesiology. Published 31 July 2023. doi:10.
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