Ventilation-Induced Lung Injury (VILI) in Neonates: Evidence-Based Concepts and Lung-Protective Strategies.
Ventilation-Induced Lung Injury (VILI) in Neonates: Evidence-Based Concepts and Lung-Protective Strategies.
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DOI：
10.3390/jcm11030557
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发表时间：
2022-01-22
影响因子：
3.9
通讯作者：
Shivanna B
中科院分区：
文献类型：
--
作者：
Kalikkot Thekkeveedu R;El-Saie A;Prakash V;Katakam L;Shivanna B
机械通气支持治疗仍然是治疗严重新生儿呼吸衰竭的重要策略;然而，众所周知，它会导致和加重新生儿肺损伤。呼吸机相关性肺损伤（VILI）的发病机制是多因素复杂的，主要是呼吸机相关因素和患者相关因素相互作用的结果。重要的是，VILI是发生支气管肺发育不良（BPD）的重要风险因素，BPD是早产儿最常见的慢性呼吸道疾病，缺乏特异性治疗，导致终身发病，并造成心理社会和经济负担。对年龄较大的儿童和成人的研究表明，了解VILI如何以及为什么发生对于制定减轻VILI及其后果的策略至关重要。本文综述了新生儿VILI的发病机制和病理生理学的临床前和临床证据。我们还强调了各种肺保护策略背后的证据，以指导临床医生预防和减轻新生儿VILI和BPD。此外，我们提供了一个快照的未来方向，可能有助于减少新生儿VILI。
Supportive care with mechanical ventilation continues to be an essential strategy for managing severe neonatal respiratory failure; however, it is well known to cause and accentuate neonatal lung injury. The pathogenesis of ventilator-induced lung injury (VILI) is multifactorial and complex, resulting predominantly from interactions between ventilator-related factors and patient-related factors. Importantly, VILI is a significant risk factor for developing bronchopulmonary dysplasia (BPD), the most common chronic respiratory morbidity of preterm infants that lacks specific therapies, causes life-long morbidities, and imposes psychosocial and economic burdens. Studies of older children and adults suggest that understanding how and why VILI occurs is essential to developing strategies for mitigating VILI and its consequences. This article reviews the preclinical and clinical evidence on the pathogenesis and pathophysiology of VILI in neonates. We also highlight the evidence behind various lung-protective strategies to guide clinicians in preventing and attenuating VILI and, by extension, BPD in neonates. Further, we provide a snapshot of future directions that may help minimize neonatal VILI.
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DOI：
10.1186/s13054-021-03853-6
发表时间：
2022-01-03
期刊：
Critical care (London, England)
影响因子：
--
作者：
Bhalla AK;Klein MJ;Modesto I Alapont V;Emeriaud G;Kneyber MCJ;Medina A;Cruces P;Diaz F;Takeuchi M;Maddux AB;Mourani PM;Camilo C;White BR;Yehya N;Pappachan J;Di Nardo M;Shein S;Newth C;Khemani R;Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
通讯作者：
Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
影响因子：
7.4
作者：
Berkelhamer, Sara K.;Kim, Gina A.;Radder, Josiah E.;Wedgwood, Stephen;Czech, Lyubov;Steinhorn, Robin H.;Schumacker, Paul T.
通讯作者：
Schumacker, Paul T.
影响因子：
2.5
作者：
Bancalari, Eduardo;Jain, Deepak
通讯作者：
Jain, Deepak
影响因子：
3.1
作者：
Chun CD;Liles WC;Frevert CW;Glenny RW;Altemeier WA
通讯作者：
Altemeier WA
影响因子：
3.7
作者：
Brown JV;Moe-Byrne T;Harden M;McGuire W
通讯作者：
McGuire W