TY - CHAP M1 - Book, Section TI - Ventilator-Induced Lung Injury A1 - Dianti, Jose A1 - Del Sorbo, Lorenzo A1 - Goligher, Ewan C. A2 - Schmidt, Gregory A. A2 - Kress, John P. A2 - Douglas, Ivor S. Y1 - 2023 N1 - T2 - Hall, Schmidt and Wood’s Principles of Critical Care, 5th Edition AB - KEY POINTSMechanical ventilation, though lifesaving, can worsen morbidity and mortality by causing ventilator-induced lung injury (VILI).VILI primarily results from the mechanical and hemodynamic effects of excess tidal stress and strain on the injured lung.Pulmonary injury and inflammation resulting from VILI decompartmentalizes through the systemic circulation to mediate multiorgan failure.Lung-protective ventilation strategies aim to minimize stress and strain applied to the lung by limiting global and regional lung-distending pressure to safe levels.Lung-protective ventilation strategies involve limiting tidal volume and driving pressure and by recruiting atelectatic lung with higher PEEP and prone positioning.Adjuvant therapies to facilitate lung-protective ventilation in carefully selected cases include neuromuscular blockade, extracorporeal life support, and high-frequency oscillation.There is growing awareness that patient respiratory muscle effort may also result in excessive and injurious lung-distending pressures (spontaneous breathing-associated lung injury).Monitoring and controlling excessive respiratory effort represent an important future area for development of the lung-protective approach to the management of hypoxemic respiratory failure. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/10/09 UR - accesssurgery.mhmedical.com/content.aspx?aid=1201803165 ER -