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Molecular Biology of Acute Lung Injury pp 289–325Cite as

Biotrauma: Signal Transduction and Gene Expression in the Lung

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Part of the book series: Molecular and Cellular Biology of Critical Care Medicine ((MCCM,volume 1))

Abstract

Mechanical injury due to artificial ventilation has been thought to play a role in lung injury for over 250 years (1). However, only recently has it become apparent that this injury is likely not confined to the lung alone, but it may contribute to the development of multi-system organ failure (MSOF) in patients with acute respiratory distress syndrome (ARDS) (2). The major cause of death in patients with ARDS is multiple organ failure, not hypoxia (3). There is little doubt that mechanical ventilation can physically disrupt the lung (4, 5). However, in addition to structural damage, it has been postulated that mechanical ventilation can also induce changes in the activation and recruitment of inflammatory cells, and stimulate the production of a number of inflammatory mediators (2). One theory, is that by altering both the pattern and magnitude of stretch, mechanical ventilation may lead to alterations in gene expression and/or cellular metabolism, ultimately leading to the development of an overwhelming generalized inflammatory response that may eventually lead to MSOF and/or death. This mechanism of injury has been termed biotrauma (2, 6).

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Authors and Affiliations

  1. Inter-Departmental Division of Critical Care, University of Toronto, Canada

    Claudia C. dos Santos, Mingyao Liu & Arthur S. Slutsky

  2. Thoracic Surgery Research Laboratory, University Health Network, Toronto General Hospital, Canada

    Claudia C. dos Santos, Mingyao Liu & Arthur S. Slutsky

  3. Department of Critical Care Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada

    Claudia C. dos Santos, Mingyao Liu & Arthur S. Slutsky

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  1. Division of Critical Care Medicine, Children’s Hospital Medical Center and Children’s Hospital Research Foundation, Cincinnati, Ohio, USA

    Hector R. Wong  & Thomas P. Shanley  & 

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dos Santos, C.C., Liu, M., Slutsky, A.S. (2001). Biotrauma: Signal Transduction and Gene Expression in the Lung. In: Wong, H.R., Shanley, T.P. (eds) Molecular Biology of Acute Lung Injury. Molecular and Cellular Biology of Critical Care Medicine, vol 1. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1427-5_19

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