Mechanisms of ventilator-induced lung injury in premature infants.
Mechanisms of ventilator-induced lung injury in premature infants.
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DOI：
10.1053/siny.2002.0129
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发表时间：
2002-10-01
期刊：
影响因子：
--
通讯作者：
Donn, Steven M
中科院分区：
文献类型：
--
作者：
Attar, Mohammad Ali;Donn, Steven M
早产儿的机械通气可能会损伤肺部或加剧导致需要机械通气的原有病症。呼吸机引起的肺损伤（VILI）可能与肺泡结构损伤、肺水肿、炎症和纤维化有关。这种损伤并不均匀，并且与表面活性剂功能障碍有关。 VILI 的恢复包括肺水肿的清除和肺泡结构的修复。 VILI 的机制包括高气道压力（气压伤）、大量气体（体积伤）、肺泡塌陷和再扩张（肺不张伤）以及炎症增加（生物伤）。肺部损伤可能会导致其他器官功能障碍。早产儿的肺部更容易受到 VILI 的影响，而肺损伤可能会加剧出生后发生的肺部发育障碍。针对肺损伤特定过程的疗法，以及补充保护性呼吸机管理策略以避免肺不张和肺过度扩张的疗法是一个活跃的研究领域。
Mechanical ventilation in premature infants may injure the lungs or exacerbate the pre-existing condition that led to the need for mechanical ventilation. Ventilator-induced lung injury (VILI) may be associated with alveolar structural damage, pulmonary oedema, inflammation, and fibrosis. This injury is not uniform and is associated with surfactant dysfunction. Recovery from VILI includes clearance of pulmonary oedema and alveolar structural repair. Mechanisms of VILI include high airway pressure (barotrauma), large gas volumes (volutrauma), alveolar collapse and re-expansion (atelectotrauma), and increased inflammation (biotrauma). Injury to the lung may lead to other organ dysfunction. The premature lung is more susceptible to VILI, and lung injury may exacerbate the disturbance of lung development that occurs after birth. Therapies targeting specific processes in lung injury, and which complement the protective ventilator management strategies to avoid atelectotrauma and lung overdistension are an area of active research.