Ventilator-Induced Lung Injury in Acute Respiratory Distress Syndrome

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Clinicians should consider the mechanism of ventilation-induced lung injury when applying evidence-based recommendations.
Clinicians should consider the mechanism of ventilation-induced lung injury when applying evidence-based recommendations.

HealthDay News — When applying evidence-based recommendations for mechanical ventilation in patients with acute respiratory distress syndrome (ARDS), clinicians should be aware of the mechanisms of ventilator-induced lung injury and the rationale behind interventions to mitigate injury, according to a literature review published in the Annals of the American Thoracic Society.

Lorenzo Del Sorbo, MD, from the University of Toronto, and colleagues conducted a literature search and narrative review of the experimental evidence relating to the pathophysiology of ventilator-induced lung injury in order to help clinicians apply clinical recommendations for mechanical ventilation to individual patients.

The researchers note that many studies have been performed with the aim of improving understanding of the pathophysiological impact of mechanical ventilation. These have formed the basis for clinical trial design. Understanding of the mechanisms of ventilator-induced lung injury has been advanced by translational research, thereby informing intervention designs that improve survival in ARDS patients.

"Because daily management of patients with ARDS presents the challenge of competing considerations, clinicians should consider the mechanism of ventilator-induced lung injury, as well as the rationale for interventions designed to mitigate it, when applying evidence-based recommendations at the bedside," the authors write.

Disclosures: Three authors disclosed ties to pharmaceutical and medical device companies.

Reference

Del Sorbo L, Goligher EC, McAuley DF, et al. Mechanical ventilation in adults with acute respiratory distress syndrome. Summary of the experimental evidence for the clinical practice guideline [published online October 1, 2017]. Ann Amer Thorac Soc. doi:10.1513/AnnalsATS.201704-345OT

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