Ectasis and pallor of peripheral airways during mechanical ventilation.
OBJECTIVE
To evaluate morphologic changes in peripheral airways associated with positive-pressure ventilation (PPV).


METHODS
Single-blind study.


METHODS
Intensive care unit of a university hospital.


METHODS
Ten patients who required mechanical ventilation due to acute respiratory failure but had no history of prior pulmonary disease.


METHODS
Seventeen fiberoptic bronchoscopy procedures were performed using a fine fiberoptic bronchoscope of 1.8 mm outside diameter.


RESULTS
The main morphologic findings were pallor and ectasis. Increased secretions, pigmentation, and stenosis or collapse in peripheral airways also were observed. Patients with ectasis were more likely to have had prolonged mechanical ventilation (17 +/- 9 days) as compared with those patients without ectasis (9 +/- 5 days).


CONCLUSIONS
The structural alterations in peripheral airways noted in patients on prolonged PPV suggest that barotrauma may be more widespread than previously recognized.
Takeda
J
J
Department of Anesthesiology and General Intensive Care Unit, Keio University, Tokyo, Japan.
Tanaka
M
M
Shimada
M
M
Ochiai
R
R
Fukushima
K
K
Kohoda
E
E
D000328:Adult; D000368:Aged; D001469:Barotrauma / Q000209:etiology / Q000473:pathology; D001980:Bronchi / Q000293:injuries / Q000473:pathology*; D001987:Bronchiectasis / Q000097:blood / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D020680:Bronchoscopes; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D011175:Positive-Pressure Respiration / Q000009:adverse effects*; D012131:Respiratory Insufficiency / Q000628:therapy; D013997:Time Factors
D010100:Oxygen