Ventilator-induced Lung Injury: Similarity and Differences between Children and Adults

Martin C.J. Kneyber, Haibo Zhang, Arthur S. Slutsky

Research output: Contribution to journalArticleAcademicpeer-review

67 Citations (Scopus)

Abstract

It is well established that mechanical ventilation can injure the lung, producing an entity known as ventilator-induced lung injury (VILI). There are various forms of VILI, including volutrauma (i.e., injury caused by overdistending the lung), atelectrauma (injury due to repeated opening/closing of lung units), and biotrauma (release of mediators that can induce lung injury or aggravate pre-existing injury, potentially leading to multiple organ failure). Experimental data in the pediatric context are in accord with the importance of VILI, and appear to show age-related susceptibility to VILI; although a conclusive link between use of large V-TS and mortality has not been demonstrated in this population. The relevance of VILI in the pediatric intensive care unit population is thus unclear. Given the physiological and biological differences in the respiratory systems of infants, children, and adults, it is difficult to directly extrapolate clinical practice from adults to children. This Critical Care Perspective analyzes the relevance of VILI to the pediatric population, and addresses why pediatric patients might be less susceptible than adults to VILI.

Original languageEnglish
Pages (from-to)258-265
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume190
Issue number3
DOIs
Publication statusPublished - 1-Aug-2014

Keywords

  • mechanical ventilation
  • ventilator-induced lung injury
  • pediatrics
  • animal studies
  • human studies
  • RESPIRATORY-DISTRESS-SYNDROME
  • TIDAL VOLUME VENTILATION
  • PEDIATRIC INTENSIVE-CARE
  • SYSTEM ORGAN FAILURE
  • TOLL-LIKE RECEPTORS
  • KAPPA-B ACTIVATION
  • MECHANICAL VENTILATION
  • INNATE IMMUNITY
  • HUMAN NEWBORN
  • PROTECTIVE-VENTILATION

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