tailieunhanh - Báo cáo y học: "Alveolar microstrain and the dark side of the lung"

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: Alveolar microstrain and the dark side of the lung. | Available online http content 11 6 177 Commentary Alveolar microstrain and the dark side of the lung Richard A Oeckler and Rolf D Hubmayr Thoracic Disease Research Unit Division of Pulmonary and Critical Care Medicine Mayo Clinic Rochester MN USA Corresponding author Rolf D Hubmayr rhubmayr@ Published 12 November 2007 This article is online at http content 11 6 177 2007 BioMed Central Ltd Critical Care 2007 11 177 doi cc6160 See related research by Pavone et al. http content 11 5 R104 Abstract Mechanical ventilation associated lung injury VALI negatively impacts the outcomes of critically ill patients. Research during the past two decades has led to a better understanding of key physiologic mechanisms of injury yet uncertainty over the topographical distribution of these mechanisms continues to fuel controversies over best ventilation practice in injured lungs. In this issue Pavone and colleagues have explored the temporal and spatial evolution of VALI in an elegant use of intravital microscopy. Their findings reinforce the notion that regions which receive most of the inspired gas in Pavone s case the non-dependent lung of a rat supported in the lateral decubitus posture are particularly susceptible to injury. However the inability to measure tissue strain remote from the pleura keeps important questions about small scale intra-acinar stress and strain distributions unanswered. Mechanical Ventilation Associated Lung Injury VALI is a prevalent complication of supportive care and greatly impacts outcomes of critically ill patients 1 2 . Research during the past two decades has identified deforming stress as a major determinant of biotrauma 3 and has drawn attention to four interrelated lung injury mechanisms regional overexpansion caused by the application of a local stress or pressure that forces cells and tissues to assume shapes and dimensions they normally would not during unassisted breathing so-called low .