Assessment of Lung Recruitment Maneuvers Using Lung Ultrasound in Comparison with Oxygenation Index in Patients with ARDS

Background: Acute Respiratory Distress Syndrome (ARDS) presents a significant challenge in critical care, with lung recruitment manoeuvres (RMs) being a pivotal treatment strategy. Lung Ultrasound (LUS) and the Oxygenation Index (OI) are two methods used to assess the efficacy of RMs, but their comparative utility remains underexplored. Objective: To evaluate the role of LUS in the assessment of lung RMs in comparison with OI in mechanically ventilated ARDS patients. Methods: In a prospective non-randomized interventional study, 48 ARDS patients undergoing mechanical ventilation were divided into two groups: the LUS group (n=27) and the OI group (n=21). LUS was performed using a curvilinear probe, and OI was determined through arterial blood gases analysis. Results: The LUS group showed a significant improvement in PFR from 99.37 ± 63.96 to 176.07 ± 77.24 (p < 0.05) after RMs, while the OI group exhibited an increase from 116.29 ± 66.69 to 197.14 ± 76.03 (p < 0.05). Both groups demonstrated significant increases in lung compliance post-RMs, with no significant difference between them (p=0.999 before RMs and p=0.875 after RMs). The optimal PEEP was slightly higher in the LUS group (17.78 ± 2.25 cmH2O) compared to the OI group (17.29 ± 2.22 cmH2O), though not statistically significant (p=0.056). Conclusion: Both LUS and OI are effective in assessing the efficacy of lung RMs in ARDS patients, with no significant difference in the improvement of peak flow rate (PFR), lung compliance, and optimal PEEP settings. LUS offers a non-invasive and readily available alternative to OI.