title: Real-time images of tidal recruitment using lung ultrasound.
abstract: BACKGROUND
  Ventilator-induced lung injury is a form of mechanical damage leading to a pulmonary inflammatory response related to the use of mechanical ventilation enhanced by the presence of atelectasis. One proposed mechanism of this injury is the repetitive opening and closing of collapsed alveoli and small airways within these atelectatic areas-a phenomenon called tidal recruitment. The presence of tidal recruitment is difficult to detect, even with high-resolution images of the lungs like CT scan. The purpose of this article is to give evidence of tidal recruitment by lung ultrasound.
  
  
  RESULTS
  A standard lung ultrasound inspection detected lung zones of atelectasis in mechanically ventilated patients. With a linear probe placed in the intercostal oblique position. We observed tidal recruitment within atelectasis as an improvement in aeration at the end of inspiration followed by the re-collapse at the end of expiration. This mechanism disappeared after the performance of a lung recruitment maneuver.
  
  
  CONCLUSIONS
  Lung ultrasound was helpful in detecting the presence of atelectasis and tidal recruitment and in confirming their resolution after a lung recruitment maneuver.
authors.affiliation: Department of Anesthesia, Hospital Privado de Comunidad, Córdoba 4545, 7600, Mar del Plata, Buenos Aires, Argentina. gtusman@hotmail.com.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Tusman
authors.affiliation: Department of Anesthesia, Hospital Privado de Comunidad, Córdoba 4545, 7600, Mar del Plata, Buenos Aires, Argentina. ceacosta77@icloud.com.
authors.forename: Cecilia M
authors.initials: CM
authors.lastname: Acosta
authors.affiliation: Department of Anesthesia, Hospital Privado de Comunidad, Córdoba 4545, 7600, Mar del Plata, Buenos Aires, Argentina. marconicola_10@hotmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Nicola
authors.affiliation: Intensive Care Medicine, Hospital Privado de Comunidad, Mar del Plata, Buenos Aires, Argentina. marianoesperatti@gmail.com.
authors.forename: Mariano
authors.initials: M
authors.lastname: Esperatti
authors.affiliation: Swisstom AG, Landquart, Switzerland. shb@egalen.com.
authors.forename: Stephan H
authors.initials: SH
authors.lastname: Bohm
authors.affiliation: Department of Surgical Sciences, Section of Anesthesia and Critical Care Hedenstierna Laboratory, Uppsala University Hospital, Uppsala, Sweden. fss@egalen.com.|CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain. fss@egalen.com.
authors.forename: Fernando
authors.initials: F
authors.lastname: Suarez-Sipmann
keywords: Atelectasis; Lung ultrasound; Recruitment maneuvers; Tidal recruitment; VILI