Bench-to-bedside review: microvascular and airspace linkage in ventilator-induced lung injury.
Experimental and clinical evidence point strongly toward the potential for microvascular stresses to influence the severity and expression of ventilator associated lung injury. Intense microvascular stresses not only influence edema but predispose to structural failure of the gas-blood barrier, possibly with adverse consequences for the lung and for extrapulmonary organs. Taking measures to lower vascular stress may offer a logical, but as yet unproven, extension of a lung-protective strategy for life support in ARDS.
Marini
John J
JJ
Professor, University of Minnesota, Regions Hospital, St Paul, Minnesota, USA. marin002@umn.edu
Hotchkiss
John R
JR
Broccard
Alain F
AF
D000818:Animals; D002199:Capillary Permeability / Q000502:physiology; D006801:Humans; D011175:Positive-Pressure Respiration; D012121:Respiration, Artificial / Q000009:adverse effects*; D012128:Respiratory Distress Syndrome / Q000145:classification / Q000209:etiology / Q000503:physiopathology*; D012720:Severity of Illness Index