TY - JOUR
T1 - The Contribution of Surface Tension-Dependent Alveolar Septal Stress Concentrations to Ventilation-Induced Lung Injury in the Acute Respiratory Distress Syndrome
AU - Perlman, Carrie E.
N1 - Publisher Copyright:
© Copyright © 2020 Perlman.
PY - 2020/6/26
Y1 - 2020/6/26
N2 - In the acute respiratory distress syndrome (ARDS), surface tension, T, is likely elevated. And mechanical ventilation of ARDS patients causes ventilation-induced lung injury (VILI), which is believed to be proportional to T. However, the mechanisms through which elevated T may contribute to VILI have been under-studied. This conceptual analysis considers experimental and theoretical evidence for static and dynamic mechanical mechanisms, at the alveolar scale, through which elevated T exacerbates VILI; potential causes of elevated T in ARDS; and T-dependent means of reducing VILI. In the last section, possible means of reducing T and improving the efficacy of recruitment maneuvers during mechanical ventilation of ARDS patients are discussed.
AB - In the acute respiratory distress syndrome (ARDS), surface tension, T, is likely elevated. And mechanical ventilation of ARDS patients causes ventilation-induced lung injury (VILI), which is believed to be proportional to T. However, the mechanisms through which elevated T may contribute to VILI have been under-studied. This conceptual analysis considers experimental and theoretical evidence for static and dynamic mechanical mechanisms, at the alveolar scale, through which elevated T exacerbates VILI; potential causes of elevated T in ARDS; and T-dependent means of reducing VILI. In the last section, possible means of reducing T and improving the efficacy of recruitment maneuvers during mechanical ventilation of ARDS patients are discussed.
KW - acute respiratory distress syndrome (ARDS)
KW - mechanical ventilation
KW - recruitment maneuvers
KW - stress concentrations
KW - surface tension
KW - ventilation-induced lung injury (VILI)
UR - http://www.scopus.com/inward/record.url?scp=85087710016&partnerID=8YFLogxK
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U2 - 10.3389/fphys.2020.00388
DO - 10.3389/fphys.2020.00388
M3 - Article
AN - SCOPUS:85087710016
VL - 11
JO - Frontiers in Physiology
JF - Frontiers in Physiology
M1 - 388
ER -