Optimal mechanical ventilation strategies to minimize ventilator-induced lung injury in non-injured and injured lungs

Silva, Pedro L.; Pelosi, Paolo; Rocco, Patricia R. M.

doi:10.1080/17476348.2016.1251842

Cited by 12 publications

(12 citation statements)

References 22 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Stress and strain are concepts borrowed from mechanical engineering that are increasingly being used to describe lung dynamics in the context of mechanical ventilation. 3 These ideas can be useful when considering the differences between conventional ventilation and APRV. Stress is defined as the applied force (encompassing pressure and area change) exerted on the lungs during mechanical ventilation.…”

Section: Physiological Rationale For the Use Of Aprvmentioning

confidence: 99%

Airway pressure release ventilation

2020

View full text Add to dashboard Cite

show abstract

Section: Physiological Rationale For the Use Of Aprvmentioning

confidence: 99%

Airway pressure release ventilation

2020

View full text Add to dashboard Cite

show abstract

“…In the presence of IAH, increased PEEP may have a deleterious impact on hemodynamics and may increase fluid and/or vasoactive drug requirements, with no effects on lung injury [8]. We chose to analyze mRNA expression of biomarkers associated with inflammation (IL-6), type II epithelial cell damage (SP-B), and endothelial cell damage (VCAM-1) in the lung because of the role of these substances as mediators in the pathogenesis of VILI [35,36]. The expression of PCIII mRNA in lung tissue was also evaluated because it this the first form of collagen to be remodeled in the course of lung fibrogenesis, and is an early marker of lung parenchymal remodeling [37].…”

Section: Discussionmentioning

confidence: 99%

Effects of pressure support and pressure-controlled ventilation on lung damage in a model of mild extrapulmonary acute lung injury with intra-abdominal hypertension

Santos

Moraes

et al. 2017

PLoS ONE

Self Cite

View full text Add to dashboard Cite

Intra-abdominal hypertension (IAH) may co-occur with the acute respiratory distress syndrome (ARDS), with significant impact on morbidity and mortality. Lung-protective controlled mechanical ventilation with low tidal volume and positive end-expiratory pressure (PEEP) has been recommended in ARDS. However, mechanical ventilation with spontaneous breathing activity may be beneficial to lung function and reduce lung damage in mild ARDS. We hypothesized that preserving spontaneous breathing activity during pressure support ventilation (PSV) would improve respiratory function and minimize ventilator-induced lung injury (VILI) compared to pressure-controlled ventilation (PCV) in mild extrapulmonary acute lung injury (ALI) with IAH. Thirty Wistar rats (334±55g) received Escherichia coli lipopolysaccharide intraperitoneally (1000μg) to induce mild extrapulmonary ALI. After 24h, animals were anesthetized and randomized to receive PCV or PSV. They were then further randomized into subgroups without or with IAH (15 mmHg) and ventilated with PCV or PSV (PEEP = 5cmH2O, driving pressure adjusted to achieve tidal volume = 6mL/kg) for 1h. Six of the 30 rats were used for molecular biology analysis and were not mechanically ventilated. The main outcome was the effect of PCV versus PSV on mRNA expression of interleukin (IL)-6 in lung tissue. Regardless of whether IAH was present, PSV resulted in lower mean airway pressure (with no differences in peak airway or peak and mean transpulmonary pressures) and less mRNA expression of biomarkers associated with lung inflammation (IL-6) and fibrogenesis (type III procollagen) than PCV. In the presence of IAH, PSV improved oxygenation; decreased alveolar collapse, interstitial edema, and diffuse alveolar damage; and increased expression of surfactant protein B as compared to PCV. In this experimental model of mild extrapulmonary ALI associated with IAH, PSV compared to PCV improved lung function and morphology and reduced type 2 epithelial cell damage.

show abstract

“…Мониторинг пищеводного (Pes) и транспульмонального давления (Ptp) позволяет оценить вклад внешнего давления на альвеолы, возникающего вследствие сдавления нижележащей легочной ткани вышележащими отделами легких, органами средостения (сердце, клетчатка средостения), органами брюшной полости и забрюшинного пространства, а также повышенного плеврального давления, например, при ожирении [19,20,75,76]. Кроме того, мониторинг пищеводного давления позволяет выделить отдельно податливость легких (C L ) и податливость грудной стенки, что позволяет оценить рекрутабельность альвеол, а соответственно и тактику респираторной терапии (C CW ) [77][78][79]…”

Section: рекомендация 10 у пациентов с ордс которым проводят ивл рunclassified

Diagnostics and intensive therapy of Acute Respiratory Distress Syndrome (Clinical guidelines of the Federation of Anesthesiologists and Reanimatologists of Russia)

Ярошецкий¹,

Грицан²,

Авдеев³

et al. 2020

Anesteziologiya I Reanimatologiya

View full text Add to dashboard Cite

РЕЗЮМЕ Рекомендации Общероссийской общественной организации «Федерация анестезиологов и реаниматологов» посвящены современному состоянию проблемы диагностики и лечения острого респираторного дистресс-синдрома. В рекомендациях использован патофизиологический подход к выбору методов интенсивной терапии и респираторной поддержки. На основании представленного анализа даны рекомендации по диагностике и лечению острого респираторного дистресс-синдрома с указанием уровня доказательности и класса рекомендаций. Ключевые слова: клинические рекомендации, острый респираторный дистресс-синдром, искусственная вентиляция легких, высокопоточная оксигенация, дыхательная недостаточность.

show abstract

Optimal mechanical ventilation strategies to minimize ventilator-induced lung injury in non-injured and injured lungs

Cited by 12 publications

References 22 publications

Airway pressure release ventilation

Airway pressure release ventilation

Effects of pressure support and pressure-controlled ventilation on lung damage in a model of mild extrapulmonary acute lung injury with intra-abdominal hypertension

Diagnostics and intensive therapy of Acute Respiratory Distress Syndrome (Clinical guidelines of the Federation of Anesthesiologists and Reanimatologists of Russia)

Contact Info

Product

Resources

About