(4) Prolonged intubation and mechanical ventilation may be associated with bronchopulmonary dysplasia (BPD) because of barotrauma,
volutrauma, and oxygen toxicity.
Results: The pathogenesis of VILI was defined gradually, from traditional pathological mechanisms (barotrauma,
volutrauma, and atelectrauma) to biotrauma.
Ventilator management is essential to prevent further pulmonary insult from high pressure volumes (
volutrauma) and peak airway pressures (barotrauma) (Arbour, 2017; Carlucci et al., 2014).
Other complications such as
volutrauma, and high FI[O.sub.2] may stimulate chemokines and cytokine inflammatory mechanisms, inducing injury to the epithelial cells.
The patient should remain during the treatment (to allow recovery of lung function) with "rest" settings (Fi[O.sub.2] 25-30%, peak inspiratory pressure (PIP) 20-25 cm [H.sub.2]O; positive end expiratory pressure (PEEP) 45 cm [H.sub.2]O; inspiratory time (Ti) 0.5-1.0 seconds; frequency (F) 20-25 breaths per minute) or even in continuous positive airway pressure (CPAP) with a high PEEP (10-12 cm [H.sub.2]O) in order to maintain functional residual capacity (FRC) without causing lung injury (
volutrauma, barotrauma, or atelectrauma).
These factors (such as inflammation, hyperoxia, barotraumas, and
volutrauma) act synergistically to cause damage to the immature lung.
Average tidal volume in the NIV group was 9-2 mL k[g.sup.-1], thought to have contributed to greater
volutrauma and thereby heightened mortality, but tidal volume was measured in neither the standard oxygen nor HFNT group.
Benefits from PCV (lower work of breathing and patient comfort)usually comes from decelerating flow waveform and benefits from VCV are related to reducing
volutrauma.23 PCV has no advantage compared to PCV if patient does not have spontaneous breathing especially if VCV uses decelerating flow.
The majority of otherwise healthy patients are capable to successfully compensate for these changes, but obese patients and those with chronic respiratory diseases are susceptible to development of numerous complications such as intraoperative hypoxia, barotrauma and
volutrauma during laparoscopic procedures (1).
This was done to minimize the risk of either barotrauma or
volutrauma; the mother had been educated by the child's pulmonologist on this specific ventilator and thus had training in its operation.
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.
Lung damage is often exacerbated by
volutrauma, hyperoxia and mechanical ventilation.
