Document Detail

Ventilator-associated lung injury.
MedLine Citation:
PMID:  10445173     Owner:  NLM     Status:  MEDLINE    
There is injury caused in numerous animal species when overdistending airway pressure and volume are delivered. The extent of this injury is attenuated by the application of PEEP. Patient case series point to the benefit of LPVS. In randomized controlled trials, the data may appear confusing. However, based on the data from the Amato and colleagues' trial, it seems prudent to employ an LPVS based on the individual patient's lung mechanics. Based on the trials discussed it appears that many have been convinced of the detrimental effects of high peak alveolar pressure. It remains to convince clinicians of the beneficial effects of the use of higher PEEP early in ARDS based on respiratory system mechanics of the individual patient and to use recruitment maneuvers. In conclusion, I concur with Dreyfuss and Saumon and Slutsky and Tremblay that the use of an LPVS may not only attenuate the severity of ARDS by preventing VALI, but may also prevent MODS or attenuate its severity.
R M Kacmarek
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  International anesthesiology clinics     Volume:  37     ISSN:  0020-5907     ISO Abbreviation:  Int Anesthesiol Clin     Publication Date:  1999  
Date Detail:
Created Date:  1999-09-17     Completed Date:  1999-09-17     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370760     Medline TA:  Int Anesthesiol Clin     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  47-64     Citation Subset:  IM    
Department of Anaesthesia, Harvard Medical School, Boston, MA, USA.
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MeSH Terms
Barotrauma / physiopathology
Cytokines / physiology
Lung Injury*
Positive-Pressure Respiration
Respiration, Artificial / adverse effects*
Wounds and Injuries / physiopathology
Reg. No./Substance:

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