| The physical basis of ventilator-induced lung injury. | |
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MedLine Citation:
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PMID: 20524920 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Although mechanical ventilation (MV) is a life-saving intervention for patients with acute respiratory distress syndrome (ARDS), it can aggravate or cause lung injury, known as ventilator-induced lung injury (VILI). The biophysical characteristics of heterogeneously injured ARDS lungs increase the parenchymal stress associated with breathing, which is further aggravated by MV. Cells, in particular those lining the capillaries, airways and alveoli, transform this strain into chemical signals (mechanotransduction). The interaction of reparative and injurious mechanotransductive pathways leads to VILI. Several attempts have been made to identify clinical surrogate measures of lung stress/strain (e.g., density changes in chest computed tomography, lower and upper inflection points of the pressure-volume curve, plateau pressure and inflammatory cytokine levels) that could be used to titrate MV. However, uncertainty about the topographical distribution of stress relative to that of the susceptibility of the cells and tissues to injury makes the existence of a single 'global' stress/strain injury threshold doubtful. |
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Authors:
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Maria Plataki; Rolf D Hubmayr |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Review |
Journal Detail:
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Title: Expert review of respiratory medicine Volume: 4 ISSN: 1747-6356 ISO Abbreviation: Expert Rev Respir Med Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-07 Completed Date: 2010-09-14 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 101278196 Medline TA: Expert Rev Respir Med Country: England |
Other Details:
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Languages: eng Pagination: 373-85 Citation Subset: IM |
Affiliation:
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Thoracic Disease Research Unit, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Biomechanics Clinical Trials as Topic Evidence-Based Medicine Humans Lung / pathology, physiopathology* Mechanotransduction, Cellular* Pressure Respiration, Artificial / adverse effects* Respiratory Distress Syndrome, Adult / pathology, physiopathology, therapy* Stress, Mechanical Ventilator-Induced Lung Injury / etiology, pathology, physiopathology* |
| Grant Support | |
ID/Acronym/Agency:
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HL63178/HL/NHLBI NIH HHS; R01 HL063178-10/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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