Abstract
Ventilator-induced lung injury (VILI) results from injury to the blood-gas barrier caused by mechanical ventilation. The determinants of VILI are more complex than originally thought, and include the nature, duration, and intensity of the exposure, as well the pattern of initial insult to the lung. Lung-protective mechanical ventilation founded on these basic principles resulted in improved hospital and long-term mortality. The purpose of this review is to provide a comprehensive assessment of the pathogenesis of VILI and its determinants. We also discuss the best preventive approach in patients with or at risk for ARDS and critically appraise the most recent evidence, expert opinion, and implementation of the acquired knowledge to the bedside.
Footnotes
- Correspondence: Ognjen Gajic MD, Division of Pulmonary and Critical Care, Mayo Clinic, 200 First Street SW, Rochester MN 55905. E-mail: gajic.ognjen{at}mayo.edu.
Dr Gajic presented a version of this paper at the 51st Respiratory Care Journal Conference, “Adult Mechanical Ventilation in Acute Care: Issues and Controversies,” held September 7 and 8, 2012, in St Petersburg, Florida.
The authors have disclosed no conflicts of interest.
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