Document Detail


Peripheral airways injury in acute lung injury/acute respiratory distress syndrome.
MedLine Citation:
PMID:  18195624     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Peripheral airways are less than 2 mm in diameter and comprise a relatively large cross-sectional area, which allows for slower, laminar airflow. They include both membranous bronchioles and gas exchange ducts, and have been referred to in the past as the 'quiet zone', partly because these structures were felt to contribute little to lung mechanics, and partly because they are difficult to study directly. RECENT FINDINGS: Recent studies suggest that peripheral airway dysfunction plays a significant role in acute respiratory distress syndrome, which may be exacerbated by injurious mechanical ventilation strategies. The presence of elevated airways resistance, intrinsic positive end-expiratory pressure or a lower inflection point on a pressure-volume curve of the respiratory system may indicate presence of impaired peripheral airway function. In-vitro animal and human studies have begun to elucidate the signaling mechanisms responsible for stretch and shear mediated cellular injury. SUMMARY: Understanding the pathophysiology of peripheral airway dysfunction in acute respiratory distress syndrome and mechanical ventilation continues to evolve. Greater insight into the signaling mechanisms involved in cellular injury and repair will lead to further alterations in mechanical ventilation strategies, and may lead to specific treatment options.
Authors:
Manu Jain; J Iasha Sznajder
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in critical care     Volume:  14     ISSN:  1070-5295     ISO Abbreviation:  Curr Opin Crit Care     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-15     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  37-43     Citation Subset:  IM    
Affiliation:
Division of Pulmonary and Critical Care, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. m-jan@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Bronchi / physiopathology
Cytokines / metabolism
Humans
Lung / physiopathology*
Respiration, Artificial / adverse effects
Respiratory Distress Syndrome, Adult / etiology,  physiopathology*
Respiratory Mechanics
Signal Transduction
Tidal Volume
Grant Support
ID/Acronym/Agency:
HL48129/HL/NHLBI NIH HHS; HL71643/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Cytokines

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


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