Formenti Paolo, Carlucci Paolo, Radovanovic Dejan, Bruno Giovanni, Soldati Gino, Tursi Francesco
SC Anestesia e Rianimazione, ASST Nord Milano.
Department of Health Sciences, Università degli Studi di Milano, Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.
Multidiscip Respir Med. 2025 Jun 3;20(1):1029. doi: 10.5826/mrm.2025.1029.
Lung collapse, commonly associated with conditions such as atelectasis, pneumonia, and acute respiratory distress syndrome, significantly impairs gas exchange and respiratory function. Monitoring lung re-aeration is therefore crucial in evaluating the effectiveness of therapeutic interventions, including non-invasive ventilation, invasive mechanical ventilation, and physiotherapy, which aim to restore lung volume and improve respiratory efficiency. Lung re-aeration involves two key physiological processes such as recruitment and inflation. Both mechanisms improve lung compliance and optimize ventilation-perfusion matching, improving overall respiratory function. LUS has emerged as a promising alternative for assessing lung aeration, supporting its feasibility in detecting and tracking lung re-aeration across various clinical scenarios, and providing real-time insights into lung recruitment and inflation. This review integrates current evidence on the physiological mechanisms of lung collapse and the clinical applications of ultrasound as a tool for monitoring lung re-aeration, highlighting its potential to optimize respiratory management in critically ill patients.
肺萎陷通常与肺不张、肺炎和急性呼吸窘迫综合征等病症相关,会显著损害气体交换和呼吸功能。因此,监测肺复张对于评估包括无创通气、有创机械通气和物理治疗在内的旨在恢复肺容积和提高呼吸效率的治疗干预措施的有效性至关重要。肺复张涉及两个关键生理过程,即肺复张和充气。这两种机制均可改善肺顺应性并优化通气-灌注匹配,从而改善整体呼吸功能。肺部超声已成为评估肺通气的一种有前景的替代方法,支持其在各种临床场景中检测和跟踪肺复张的可行性,并提供有关肺复张和充气的实时见解。本综述整合了关于肺萎陷生理机制的现有证据以及超声作为监测肺复张工具的临床应用,强调其在优化危重症患者呼吸管理方面的潜力。