[Lung damage due to mechanical ventilation].

Abstract

Mechanical ventilation in both children and adults is still associated with development of lung injury, both short term and long term. In particular, ventilation with high tidal volumes and low positive end-expiratory pressures (PEEP) contributes significantly to development of lung injury. Suggested preventive measures consist of limiting peak inflation pressures, preventing high tidal volumes, and applying high PEEP to prevent alveolar collapse. Recent studies have demonstrated that mechanical ventilation, via stretch of lung tissue, results in an inflammatory reaction in the lungs. This is known as biotrauma. The degree of inflammation depends on the ventilator settings and mode of ventilation. This inflammatory reaction may not be limited to the lungs but, via inflammatory mediators, may cause multiple organ dysfunction as well. Future research needs to be concentrated on how to modify this ventilator induced inflammatory reaction in order to prevent lung injury as well as systemic injury.