Journal ArticleDOI
Ventilator-induced lung injury: lessons from experimental studies.
Didier Dreyfuss,Georges Saumon +1 more
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TLDR
This paper presents experimental evidence for Increased Vascular Transmural Pressure Evidence for Alterations in Alveolar–Capillary Permeability Contributions of the Static and Dynamic Lung Volume Components to Ventilator-induced Edema High-volume Lung Edema Low Lung Volume Injury.Abstract:
Introduction: Ventilator-induced Lung Injury: Not Only Air Leaks Ventilation-induced Pulmonary Edema and Related Findings: A Historical Perspective Ventilation-induced Pulmonary Edema: Hydrostatic or Permeability Edema? Experimental Evidence for Increased Vascular Transmural Pressure Evidence for Alterations in Alveolar–Capillary Permeability Contributions of the Static and Dynamic Lung Volume Components to Ventilator-induced Edema High-volume Lung Edema Low Lung Volume Injury Effects of High-volume Ventilation on Abnormal Lungs Effects of High-volume Ventilation on Injured Lungs Interaction between Severe Alveolar Flooding and Mechanical Ventilation Effects of Resting the Lung on Ventilator-induced Lung Injury Possible Mechanisms of Ventilation-induced Lung Injury Mechanisms of Increased Vascular Transmural Pressure Mechanisms of Altered Permeability Clinical Relevanceread more
Citations
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Journal ArticleDOI
Higher versus Lower Positive End-Expiratory Pressures in Patients with the Acute Respiratory Distress Syndrome
Roy G. Brower,Paul N. Lanken,Neil R. MacIntyre,Michael A. Matthay,Alan H. Morris,Marek Ancukiewicz,David A. Schoenfeld,B. Taylor Thompson +7 more
TL;DR: In patients with acute lung injury and ARDS who receive mechanical ventilation with a tidal-volume goal of 6 ml per kilogram of predicted body weight and an end-inspiratory plateau-pressure limit of 30 cm of water, clinical outcomes are similar whether lower or higher PEEP levels are used.
Journal ArticleDOI
Animal models of acute lung injury.
TL;DR: The goal of this review is to summarize the strengths and weaknesses of existing models of lung injury and help guide investigators in the design and interpretation of animal studies of acute lung injury.
Journal ArticleDOI
Ventilator-Induced Lung Injury
TL;DR: The probable causes of mechanical ventilation injury and ways to prevent it are reviewed.
Journal ArticleDOI
Higher vs Lower Positive End-Expiratory Pressure in Patients With Acute Lung Injury and Acute Respiratory Distress Syndrome: Systematic Review and Meta-analysis
Matthias Briel,Maureen O. Meade,Alain Mercat,Roy G. Brower,Daniel Talmor,Stephen D. Walter,Arthur S. Slutsky,Eleanor Pullenayegum,Qi Zhou,Deborah J. Cook,Laurent Brochard,Jean-Christophe Richard,Francois Lamontagne,Francois Lamontagne,Neera Bhatnagar,Thomas E. Stewart,Gordon H. Guyatt +16 more
TL;DR: Evaluating the association of higher vs lower PEEP with patient-important outcomes in adults with acute lung injury or ARDS who are receiving ventilation with low tidal volumes found that higher levels were associated with improved survival among the subgroup of patients with ARDS, but lower levels were not associated withImproved hospital survival.
Journal ArticleDOI
Lung Recruitment in Patients with the Acute Respiratory Distress Syndrome
Luciano Gattinoni,Pietro Caironi,Massimo Cressoni,Davide Chiumello,V. Marco Ranieri,Michael Quintel,Sebastiano G. Russo,Nicolò Patroniti,Rodrigo Cornejo,Guillermo Bugedo +9 more
TL;DR: In ARDS, the percentage of potentially recruitable lung is extremely variable and is strongly associated with the response to PEEP, which may decrease ventilator-induced lung injury by keeping lung regions open that otherwise would be collapsed.
References
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Journal ArticleDOI
Definitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in Sepsis
Roger C. Bone,Robert A. Balk,F. B. Cerra,R. P. Dellinger,A. M. Fein,William A. Knaus,Roland M. H. Schein,W. J. Sibbald +7 more
TL;DR: An American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference was held in Northbrook in August 1991 with the goal of agreeing on a set of definitions that could be applied to patients with sepsis and its sequelae as mentioned in this paper.
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High Inflation Pressure Pulmonary Edema: Respective Effects of High Airway Pressure, High Tidal Volume, and Positive End-expiratory Pressure
TL;DR: To the authors' knowledge, this constitutes the first example of a protective effect of PEEP during permeability edema, which was markedly reduced by PEEP and preserved the normal ultrastructural aspect of the alveolar epithelium.
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Injurious ventilatory strategies increase cytokines and c-fos m-RNA expression in an isolated rat lung model.
TL;DR: The concept that mechanical ventilation can have a significant influence on the inflammatory/anti-inflammatory milieu of the lung, and thus play a role in initiating or propagating a local, and possibly systemic inflammatory response, is supported.
Journal ArticleDOI
Stress distribution in lungs: a model of pulmonary elasticity
TL;DR: The principal functional risk that it entails is increase in capillary transmural pressure in regions which become subjected to abnormally high outward-acting stress, and in the appropriate sign to reduce the nonuniformity.
Journal ArticleDOI
Tidal ventilation at low airway pressures can augment lung injury.
TL;DR: End-expiratory lung volume is an important determinant of the degree and site of lung injury during positive-pressure ventilation as ventilation occurs from below to above the infection point (Pinf) as determined from the inspiratory pressure-volume curve.