[Mechanical ventilation induced lung injury].
Mechanical ventilation is associated with important complications, among which production or perpetuation of acute lung injury and product of distant organ injuries of the lung basically through the release of inflammatory mediators to the systemic circulation. There is increasingly greater evidence in both in vitro and in vivo experimental models that show the reality of this lesional mechanism. The main lesional mechanisms are both stretching and rupture of the lung structures (volutrauma) and cyclical opening and closure of the closed alveolar zones (atelectrauma). Studies on the use of protective lung ventilation strategies have shown a beneficial effect in patients with ARDS of the use of open lung ventilation strategies, use of circulating volumes less than 10 ml/kg and of maintaining alveolar pressure under 30 cm of H2O. It should be investigated if these same strategies would be useful in preventing the appearance of ARDS in mechanically ventilated patients for another reason, basically in those with risk factors for the development of this condition.
Gordo Vidal
F
F
Area de Anestesia, Reanimación y Cuidados Críticos, Fundación Hospital Alcorcón, Alcorcón, Madrid, España. fgordo@fhalcorcon.es
Delgado Arnaiz
C
C
Calvo Herranz
E
E
D006801:Humans; D053717:Pneumonia, Ventilator-Associated / Q000209:etiology*; D012121:Respiration, Artificial / Q000009:adverse effects*; D012128:Respiratory Distress Syndrome / Q000209:etiology*