Ventilator induced lung injury: a case for a larger umbrella?
Luciano Gattinoni, Francesca Collino, Luigi Camporota
Abstract
Mechanical ventilation and VILIVentilator-induced lung injury (VILI) is a general term indicating the structural and physiological lung alterations caused by mechanical ventilation (MV).Given that MV is only a supportive treatment, the best MV settings are those providing sufficient gas exchange without generating additional injury.Therefore, VILI detection allows to discriminate between an "innocent" and a "harmful" MV. Conceptual and mechanistic evolution of ventilator-induced lung injury BarotraumaThis was the first described injury associated with MV in acute respiratory distress syndrome (ARDS).The mechanism of these injuries was elucidated by Macklin et al. [1], who found that alveolar rupture leads to a gas escaping along the pulmonary vascular sheaths toward the mediastinum with consequent pneumomediastinum, subcutaneous emphysema, and pneumothorax.