Novel approaches to minimize ventilator-induced lung injury

BMC Medicine

Arthur S Slutsky¹  Jesus Villar¹  Eddy Fan² 

[1] Keenan Research Center at the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada;Department of Medicine, Mount Sinai Hospital and University Health Network, Toronto, Canada

关键词: Ventilatory support;    Mechanical ventilation;    Heat shock response;    Extracorporeal membrane oxygenation;    Cytokines;    Critical illness;    Acute respiratory distress syndrome;    Acute lung injury;   

Others  :  857124
DOI  :  10.1186/1741-7015-11-85

 received in 2012-11-30, accepted in 2013-02-07,  发布年份 2013

【 摘 要 】

Despite over 40 years of research, there is no specific lung-directed therapy for the acute respiratory distress syndrome (ARDS). Although much has evolved in our understanding of its pathogenesis and factors affecting patient outcome, supportive care with mechanical ventilation remains the cornerstone of treatment. Perhaps the most important advance in ARDS research has been the recognition that mechanical ventilation, although necessary to preserve life, can itself aggravate or cause lung damage through a variety of mechanisms collectively referred to as ventilator-induced lung injury (VILI). This improved understanding of ARDS and VILI has been important in designing lung-protective ventilatory strategies aimed at attenuating VILI and improving outcomes. Considerable effort has been made to enhance our mechanistic understanding of VILI and to develop new ventilatory strategies and therapeutic interventions to prevent and ameliorate VILI with the goal of improving outcomes in patients with ARDS. In this review, we will review the pathophysiology of VILI, discuss a number of novel physiological approaches for minimizing VILI, therapies to counteract biotrauma, and highlight a number of experimental studies to support these concepts.

【 授权许可】

   
2013 Fan et al.; licensee BioMed Central Ltd.

【 图 表 】

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