CT Registration-Derived Biomarkers of Recruitability in Ards

Mechanical ventilation in patients with acute respiratory failure can induce or worsen lung injury due to excessive mechanical stress on the lung tissue. Regional lung overinflation, cyclic recruitment, focal stresses due to mechanical heterogeneity, and increased delivery of mechanical power are contributing mechanisms. Accurate biomarkers of lung function could help minimize the risk of ventilator-induced lung injury through personalized ventilator settings. Here we propose new registration-derived biomarkers of lung function based on the joint histogram of lung computed-tomography scans at two different positive end-expiratory pressure levels. We compare two calculation methods, and demonstrate that the obtained parameters can be interpreted as indices of recruitability and overinflation.