RT Book, Section
A1 Dianti, Jose
A1 Del Sorbo, Lorenzo
A1 Goligher, Ewan C.
A2 Schmidt, Gregory A.
A2 Kress, John P.
A2 Douglas, Ivor S.
SR Print(0)
ID 1201803165
T1 Ventilator-Induced Lung Injury
T2 Hall, Schmidt and Wood’s Principles of Critical Care, 5<sup>th</sup> Edition
YR 2023
FD 2023
PB McGraw Hill
PP New York, NY
SN 9781264264353
LK accesssurgery.mhmedical.com/content.aspx?aid=1201803165
RD 2024/10/03
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.