Document Detail

Mechanisms of acute respiratory distress syndrome: role of surfactant changes and mechanical ventilation.
MedLine Citation:
PMID:  9444607     Owner:  NLM     Status:  MEDLINE    
Acute respiratory distress syndrome (ARDS) is a condition characterized by a high permeability oedema due to loss of the integrity of the alveolo-capillary barrier with impairment of normal surfactant function, resulting in an increased collapse tendency of the alveoli. Mechanical ventilation on such alveoli with repeated alveolar collapse and subsequent reexpansion results in severe lung parenchymal injury and may induce further surfactant impairment. This cam be prevented by maintaining alveolar volume at end-expiration by means of sufficient levels of positive end-expiratory pressure (PEEP). Recent evidence from experimental studies has shown that ventilator modes which allow end-expiratory collapse can induce bacterial translocation from the lung into the bloodstream and trigger the release of inflammatory mediators, which can also be presented by maintaining end-expiratory alveolar volume. These data suggest that the interaction between surfactant changes and mechanical ventilation may play a role in the transition of ARDS into the systematic inflammatory disease process of multiple system organ failure (MSOF).
S J Verbrugge; V Sorm; B Lachmann
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of physiology and pharmacology : an official journal of the Polish Physiological Society     Volume:  48     ISSN:  0867-5910     ISO Abbreviation:  J. Physiol. Pharmacol.     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-03-03     Completed Date:  1998-03-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9114501     Medline TA:  J Physiol Pharmacol     Country:  POLAND    
Other Details:
Languages:  eng     Pagination:  537-57     Citation Subset:  IM    
Department of Anesthesiology, Erasmus University Rotterdam, The Netherlands.
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MeSH Terms
Lung / physiopathology*
Pulmonary Surfactants / physiology*
Respiration, Artificial / adverse effects*
Respiratory Distress Syndrome, Adult / etiology,  physiopathology*,  prevention & control
Systemic Inflammatory Response Syndrome / physiopathology
Reg. No./Substance:
0/Pulmonary Surfactants

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