Document Detail


Mechanisms of ventilation-induced lung injury: physiological rationale to prevent it.
MedLine Citation:
PMID:  10218368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It is being increasingly realized that modes of mechanical ventilation that result in end-inspiratory alveolar overstretching and/or repeated alveolar collapse and re-expansion disturb the normal fluid balance across the alveolocapillary membrane. The effects of this include disturbance of the integrity of the endothelium and epithelium and impairment of the surfactant system and are similar to those seen in acute respiratory distress syndrome (ARDS). There is now also evidence that these modes of mechanical ventilation may result in the translocation of bacteria from the lungs into the bloodstream and the release of inflammatory mediators from the lung tissue into the systemic circulation. It may thus be speculated that mechanical ventilation may contribute to the development of multiple organ failure (MOF). Therefore, during mechanical ventilation, alveolar overstretching and the repeated collapse and re-expansion of alveoli should be prevented by ventilation modes that open up the lung and keep the lung open and ventilate with the smallest possible pressure amplitude. For the future, monitoring techniques should be developed that can evaluate, on-line, whether or not these therapeutic directives are being achieved.
Authors:
S J Verbrugge; B Lachmann
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo     Volume:  54     ISSN:  1122-0643     ISO Abbreviation:  Monaldi Arch Chest Dis     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-07-08     Completed Date:  1999-07-08     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9307314     Medline TA:  Monaldi Arch Chest Dis     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  22-37     Citation Subset:  IM    
Affiliation:
Dept of Anaesthesiology, Erasmus University Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cytokines / metabolism
Humans
Infant, Newborn
Lung / physiology
Lung Injury*
Pulmonary Alveoli / metabolism
Pulmonary Surfactants / metabolism
Respiration, Artificial / adverse effects*
Respiratory Distress Syndrome, Newborn / metabolism,  therapy
Respiratory Function Tests
Water-Electrolyte Balance
Chemical
Reg. No./Substance:
0/Cytokines; 0/Pulmonary Surfactants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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