Data Sources: This review was based on articles in the PubMed database up to December 2017 using the following keywords: 'ventilator-induced lung injury', 'pathogenesis', 'mechanism', and 'biotrauma
and ventilator-induced lung injury: clinical implications," Chest, vol.
The underlying mechanisms of VILI include alveolar overdistension (volutrauma), alveolar instability leading to alveolar collapse and reopening with each breath (atelectrauma), and the secondary inflammation caused by these mechanical injuries which is known as biotrauma
Sustained mechanical distension of the lungs due to hyperinflation, contributes to volutrauma, barotrauma, and biotrauma
, which may cause intensive stress leading to direct cell injury.
Ventilator-induced lung injury: from barotrauma to biotrauma
VILI is a complex collection of lung deconstuctive elements that manifests itself in a number of forms including but is not limited to the following categories of ventilator induced lung injury; Volutrama, Barotrauma, Biotrauma
, RACE and Atelectrauma.
This is especially true with increasing awareness of the complications of mechanical ventilation, such as barotrauma, volutrauma and biotrauma
Major underlying mechanisms have indicated that the injury includes volutrauma due to alveolar overdistension, atelectrauma due to ventilation at low lung volumes, and biotrauma
with the release of mediators in the lung. However, there are limited methods to prevent VILI, protect the lung issue, and avoid the damage.
Ventilator-associated lung injury (VILI) includes barotrauma, volutrauma, atelectrauma, and biotrauma
, among which volutrauma, the overexpansion produced by high tidal volume, is the major cause of VILI [1,16,17].
HFV helps to reduce barotrauma with low pressures, biotrauma
Mechanical ventilation (MV) is an important treatment for acute respiratory failure (ARF) in that it can improve hypoxemia, maintain lung volumes, and recruit alveoli collapse.[sup] However, because of barotrauma, volutrauma, and biotrauma
, MV could cause or aggravate acute lung injury not only in acute respiratory distress syndrome (ARDS) patients but also in patients with normal lung function.[sup],
What must not be overlooked is that these life sustaining devices, if not properly managed, can cause or are associated with life threatening complications including volutrauma, barotrauma, biotrauma
, tracheal injury, ventilator associated pneumonia and multi-system organ failure.