复张-膨胀比评估急性呼吸窘迫综合征肺可复张性的研究进展OA

Acute respiratory distress syndrome(ARDS)is characterized by heterogeneous alveolar collapse and refractory hypoxemia,posing significant challenges to the optimization of mechanical ventilation strategies.Given the substantial inter-patient variability in lung recruitability,optimal approaches for lung recruitment maneuvers(RMs)and positive end-expiratory pressure(PEEP)settings remain controversial.The recruitment-to-inflation ratio(R/I),a recently proposed bedside assessment tool,quantifies alveolar recruitability by analyzing changes in respiratory system compliance across different PEEP levels,thereby providing a basis for individualized ventilation strategies.R/I is simple to perform,requires no additional equipment,and can be repeatedly measured at the bedside to dynamically track treatment responses.Multiple studies have demonstrated good agreement between R/I and recruitability assessed by computed tomography,electrical impedance tomography,and lung ultrasound.However,the current evidence is predominantly derived from small-sample,single-center studies.Measurement discrepancies across different ventilator models may compromise the accuracy of R/I,and no universally accepted threshold for distinguishing high from low recruitability has been established.Future large-scale,multicenter clinical trials are warranted to further validate the reliability of R/I and to clarify its clinical value in balancing the benefits of lung recruitment against the risk of ventilator-induced lung injury in ARDS management.