Measurement of alveolar recruitment at the bedside: the beginning of a new era in respiratory monitoring?

In this issue of RESPIRATORY CARE, Wallet and coworkers bring convincing evidence that PEEP-induced alveolar recruitment can be inferred from regional changes in lung densities computed on frontal bedside digital chest radiographies obtained at 2 different PEEP levels in patients with ARDS.1 The reference method for the comparison was the pressure-volume (PV) curve method, one of the methods commercially available at the bedside for measuring PEEP-induced alveolar recruitment. This original finding renews the place of bedside chest radiographies that are routinely performed in critically ill patients with ARDS: they could serve not only as a qualitative tool for assessing lung aeration but also as a monitoring tool for quantifying alveolar recruitment.