This reference surveys current best practices in the prevention and management of ventilator-induced lung injury (VILI) and spans the many pathways and mechanisms of VILI including cell injury and repair, the modulation of alveolar-capillary barrier properties, and lung and systemic inflammatory consequences of injurous mechanical ventilation. Considering many emerging therapeutic options, this guide also reviews the wide array of clinical studies on lung protection strategies and approaches to ARDS patients at risk for VILI.
Table of Contents
INTRODUCTION. Ventilator-Induced Lung Injury: From Bench to Bedside and Back Again. ACUTE MANIFESTATIONS OF VILI. Pathological Features of ARDS and VILI. Imaging Alveolar Mechanics During VILI. Response of Cellular Plasma Membrane to Mechanical Stress. Passive and Active Changes in Microcascular Permeability During Lung Distension. Meodynamic Interactions During VILI. Gene Expression During VILI. Lung Mechanics and VILI. Effects of Acute Lung Distension on the Cytokine Network. SUBACUTE VILI. Inflammation Cascade During VILI. Apoptosis in the Lung and Remote Organs During VILI. Systemic Consequences of VILI/Evidence for Organ Failure Causation. Interaction of VILI with Previous Lung Alterations. Modulation of Lung Injury by Hypercapnia. Potential Implications of Genomics in the Prevention and Treatment of VILI. CLINICAL IMPLICATIONS OF VILI. Lung Imaging of Ventilator-Associated Injury. The Future of Lung Imaging of VILI/VALI. Modulation of the Cytokine Network by Lung Protective Mechanical Ventilation Strategies. Role of Tidal Volume and of Peep in the Reduction of Ventilator-Associated Lung Injury. A Critical Review of Randomized Controls of Tidal Volume Reduction During ARDS. PREVENTION AND TREATMENT OF VILI. The Importance of Protocol-Directed Management for Research on Lung Protective Ventilation. How to Design Clinical Studies for the Prevention of Ventilator-Associated Lung Injury? Potential Benefits and Risks of Partial Liquid Ventilation During Acute Lung Injury. Prospects for Reduction of VILI with Surfactant. Rationale for HFO Ventilations in Acute Lung Injury