Mechanisms of ventilator‐induced lung injury

  title={Mechanisms of ventilator‐induced lung injury},
  author={James Courtney Parker and Keith J. Peevy},
  journal={Critical Care Medicine},
ObjectivesTo describe the physiologic mechanisms of ventilator-induced lung injury and to define the major ventilator and host-dependent risk factors that contribute to such injury. Data SourcesBasic science and clinical studies related to ventilator-induced barotrauma and lung pathophysiology. Study SelectionEmphasis on controlled, experimental studies and clinical studies related to specific mechanisms. Data ExtractionPreference given to studies with quantitative end-points to assess damage… 
Ventilator-induced lung injury and implications for clinical management.
  • C. Edibam
  • Medicine
    Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine
  • 2000
Ventilator-induced lung injury is an iatrogenic disturbance that increases morbidity and mortality associated with acute respiratory distress syndrome and tidal volume reduction and increased levels of PEEP have reduced inflammatory mediators and the mortalityassociated with ARDS.
Mechanisms of ventilator-induced lung injury in premature infants.
The premature lung is more susceptible to VILI, and lung injury may exacerbate the disturbance of lung development that occurs after birth, andTherapies targeting specific processes in lung injury, and which complement the protective ventilator management strategies, are an area of active research.
Ventilator-induced lung injury.
Invited review: mechanisms of ventilator-induced lung injury: a perspective.
A perspective on ventilator-induced lung injury is presented with a focus on mechanisms and clinical implications, and some of the most recent findings are highlighted, which are believed to contribute to the generation and propagation of ventilated lung injury.
Ventilation-induced lung injury and mechanotransduction: stretching it too far?
  • S. Uhlig
  • Medicine, Biology
    American journal of physiology. Lung cellular and molecular physiology
  • 2002
Different mechanisms should be taken into account in the design and the interpretation of studies on molecular mechanisms of ventilation-induced lung injury, including vascular shear stress and known stimuli for endothelial cells.
Ventilator-induced lung injury and multiple system organ failure: a critical review of facts and hypotheses
The proposed mechanisms linking mechanical ventilation and MSOF suggest several novel therapeutic approaches and it is suggested that scientific advances in immunology may offer novel approaches for prevention of MSOF secondary to ventilator-induced lung injury.
Ventilator-induced endothelial activation and inflammation in the lung and distal organs
Alveolar stretch imposed by MV did not only induce de novo synthesis of adhesion molecules in the lung but also in organs distal to the lung, like liver and kidney, when applied in vivo.
Carbon dioxide attenuates pulmonary impairment resulting from hyperventilation*
At clinically relevant tidal volume, CO2 modulates key physiologic indices of lung injury, including alveolar-arterial oxygen gradient and airway pressure, indicating a potential role in the pathogenesis of ventilator-associated lung injury.
Ventilator-Associated Systemic Inflammation
In patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) higher systemic and intra-alveolar levels of pro-inflammatory cytokines have been observed in recent investigations during mechanical ventilation with low PEEP and high tidal volumes.
Physical and biological triggers of ventilator-induced lung injury and its prevention
In order to prevent initiation of ventilator-induced lung injury, transpulmonary pressure must be kept within the physiological range, and the contradictory results of the randomised trials dealing with different strategies of mechanical ventilation may be better understood.