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Báo cáo khoa học: "Bench-to-bedside review: Microvascular and airspace linkage in ventilator-induced lung injury"
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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Bench-to-bedside review: Microvascular and airspace linkage in ventilator-induced lung injury. | Available online http ccforum.eom content 7 6 435 Review Bench-to-bedside review Microvascular and airspace linkage in ventilator-induced lung injury John J Marini1 John R Hotchkiss2 and Alain F Broccard3 1 Professor University of Minnesota Regions Hospital St Paul Minnesota USA 2Assistant Professor University of Minnesota Regions Hospital St Paul Minnesota USA 3Associate Professor University of Minnesota Regions Hospital St Paul Minnesota USA Correspondence John J Marini marin002@umn.edu Published online 17 October 2003 Critical Care 2003 7 435-444 DOI 10.1186 cc2392 This article is online at http ccforum.com content 7 6 435 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Experimental and clinical evidence point strongly toward the potential for microvascular stresses to influence the severity and expression of ventilator associated lung injury. Intense microvascular stresses not only influence edema but predispose to structural failure of the gas-blood barrier possibly with adverse consequences for the lung and for extrapulmonary organs. Taking measures to lower vascular stress may offer a logical but as yet unproven extension of a lung-protective strategy for life support in ARDS. Keywords acute respiratory distress syndrome capillary stress fracture mechanical ventilation vascular injury ventilator-induced lung injury Introduction Although ventilator-induced lung injury VILI is undoubtedly a complex process that is influenced by many factors the great majority of investigative attention has been directed at airspace mechanics as exemplified by tidal volume plateau pressure and positive end-expiratory pressure PEEP . However because the fragile alveolus serves as the interface between gas and blood and because the intraluminal pressures applied to the airway epithelium also impact on the vascular endothelium the potential for pressures and flows within blood vessels to influence the development and or evolution of VILI also deserves .