Ventilator-induced Lung Injury

Jeremy R Beitler; Atul Malhotra; B Taylor Thompson

doi:10.1016/j.ccm.2016.07.004

Ventilator-induced Lung Injury

Clin Chest Med. 2016 Dec;37(4):633-646. doi: 10.1016/j.ccm.2016.07.004. Epub 2016 Oct 14.

Authors

Jeremy R Beitler¹, Atul Malhotra², B Taylor Thompson³

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, University of California, San Diego, 200 West Arbor Drive, #8409, San Diego, CA 92103, USA. Electronic address: jbeitler@ucsd.edu.
² Division of Pulmonary and Critical Care Medicine, University of California, San Diego, 200 West Arbor Drive, #8409, San Diego, CA 92103, USA.
³ Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 55 Fruit Street, Cox 201, Boston, MA 02114, USA.

Abstract

Prevention of ventilator-induced lung injury (VILI) can attenuate multiorgan failure and improve survival in at-risk patients. Clinically significant VILI occurs from volutrauma, barotrauma, atelectrauma, biotrauma, and shear strain. Differences in regional mechanics are important in VILI pathogenesis. Several interventions are available to protect against VILI. However, most patients at risk of lung injury do not develop VILI. VILI occurs most readily in patients with concomitant physiologic insults. VILI prevention strategies must balance risk of lung injury with untoward side effects from the preventive effort, and may be most effective when targeted to subsets of patients at increased risk.

Keywords: Acute lung injury; Acute respiratory distress syndrome; Mechanical ventilation; Respiratory mechanics; Ventilator-induced lung injury.

Publication types

Review

MeSH terms

Humans
Lung Injury / pathology*
Respiratory Distress Syndrome / therapy*
Respiratory Mechanics / physiology*
Ventilator-Induced Lung Injury*

Abstract

Publication types

MeSH terms

Grants and funding