Ventilator-associated lung injury

Ventilator-associated lung injury (VALI) is a type of lung injury that occurs as a result of mechanical ventilation. It is a significant concern in intensive care medicine, as it can lead to increased morbidity and mortality in critically ill patients.

Causes

VALI can be caused by a variety of factors, including high tidal volume ventilation, high positive end-expiratory pressure (PEEP), and repeated opening and closing of alveoli. These factors can lead to barotrauma, volutrauma, and atelectrauma, respectively, all of which can contribute to the development of VALI.

Pathophysiology

The pathophysiology of VALI involves a complex interplay of mechanical forces and biological responses. Mechanical forces from the ventilator can cause physical damage to the lung tissue, leading to pulmonary edema and inflammation. This can trigger a cascade of biological responses, including the release of proinflammatory cytokines and oxidative stress, which can further damage the lung tissue and lead to acute respiratory distress syndrome (ARDS).

Prevention and Management

Prevention and management of VALI involve strategies to minimize the risk factors associated with mechanical ventilation. These include lung-protective ventilation strategies, such as low tidal volume ventilation and optimal PEEP settings. In addition, prone positioning and neuromuscular blockade may be used in certain cases to reduce the risk of VALI.

See Also

• Acute respiratory distress syndrome
• Barotrauma
• Volutrauma
• Atelectrauma
• Pulmonary edema
• Inflammation
• Proinflammatory cytokines
• Oxidative stress
• Prone positioning
• Neuromuscular blockade