Acute lung injury: how to stabilize a broken lung

• Main Authors: Gary F. Nieman, Penny Andrews, Joshua Satalin, Kailyn Wilcox, Michaela Kollisch-Singule, Maria Madden, Hani Aiash, Sarah J. Blair, Louis A. Gatto, Nader M. Habashi
• Format: Article
• Language: English
• Published: BMC 2018-05-01
• Series: Critical Care
• Subjects: Acute lung injury; Injurious mechanical ventilation; TCAV protocol
• Online Access: http://link.springer.com/article/10.1186/s13054-018-2051-8

Abstract The pathophysiology of acute respiratory distress syndrome (ARDS) results in heterogeneous lung collapse, edema-flooded airways and unstable alveoli. These pathologic alterations in alveolar mechanics (i.e. dynamic change in alveolar size and shape with each breath) predispose the lung to secondary ventilator-induced lung injury (VILI). It is our viewpoint that the acutely injured lung can be recruited and stabilized with a mechanical breath until it heals, much like casting a broken bone until it mends. If the lung can be “casted” with a mechanical breath, VILI could be prevented and ARDS incidence significantly reduced.