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Close Down the Lungs and Keep them Resting to Minimize Ventilator-induced Lung Injury

  • P. PelosiEmail author
  • P. R. M. Rocco
  • M. Gama de Abreu
Chapter
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)

Introduction

Mechanical ventilation is needed to support respiratory function in different clinical conditions, from healthy to diseased lungs. However, in recent years, research has shown that mechanical ventilation may promote acute and chronic damage to pulmonary structures, the so‐called ventilator‐induced lung injury (VILI), especially in patients with acute respiratory distress syndrome (ARDS) [1]. ARDS is characterized by a loss of aerated lung tissue as a result of edema and atelectasis, which reduces respiratory system compliance and impairs gas exchange. Several mechanisms have been identified that may underlie VILI. Those considered most important are alveolar overdistension and the continuous opening and closing of atelectatic lung units during breath cycles [2]. As a consequence, clinical use of lower tidal volume (VT) to achieve reduced inspiratory stress and strain (‘gentle’ ventilation of the aerated lung), combined with higher levels of positive end‐expiratory...

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Surgical Sciences and Integrated Diagnostics, San Martino Policlinico Hospital, IRCCS for OncologyUniversity of GenoaGenoaItaly
  2. 2.Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of BiophysicsFederal University of Rio de JaneiroRio de JaneiroBrazil
  3. 3.Department of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, University Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany

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