Lung recruitment maneuvers using direct ultrasound guidance: a case study

Previous studies have shown that lung recruitment maneuvers are important means of treating ARDS. Although computed tomography (CT) scans and pressure-volume curves are the most common ways to evaluate lung recruitment, there are still many disadvantages. Not only do the scans have to take place in a CT room, but the patient is exposed to large doses of radiation through the multiple scans necessary to define the optimal PEEP. Pressure-volume curves require deep sedation and muscle relaxation. Thus, bedside lung ultrasound may be considered to be a safer and easier alternative to CT scans or pressure-volume curves. In our case, we evaluated the effectiveness of lung recruitment with a bedside ultrasound on a patient who was suffering from life-threatening hypoxemia. Bedside ultrasound is a faster and more convenient imaging method because it reduces the need for patient transport compared with CT scan and requires no muscle relaxation. This case supports that ultrasound may become an alternative imaging tool to guide and evaluate alveolar recruitment in patients with ARDS. Additionally, we have also included a brief review of lung recruitment evaluation by ultrasound to supplement this case study.