title: Ectasis and pallor of peripheral airways during mechanical ventilation.
abstract: 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.
authors: Department of Anesthesiology and General Intensive Care Unit, Keio University, Tokyo, Japan.
authors: J
authors: J
authors: Takeda
authors: M
authors: M
authors: Tanaka
authors: M
authors: M
authors: Shimada
authors: R
authors: R
authors: Ochiai
authors: K
authors: K
authors: Fukushima
authors: E
authors: E
authors: Kohoda
mesh_terms: 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
chemical_list: D010100:Oxygen