Lung Stress and Strain during Mechanical Ventilation for Acute Respiratory Distress Syndrome

• Published in: American journal of respiratory and critical care medicine Vol. 178; no. 4; pp. 346 - 355
• Main Authors: Chiumello, Davide, Carlesso, Eleonora, Cadringher, Paolo, Caironi, Pietro, Valenza, Franco, Polli, Federico, Tallarini, Federica, Cozzi, Paola, Cressoni, Massimo, Colombo, Angelo, Marini, John J, Gattinoni, Luciano
• Format: Journal Article
• Language: English
• Published: New York, NY Am Thoracic Soc 15.08.2008; American Lung Association; American Thoracic Society
• Subjects: Adult; Aged; Airway Resistance - physiology; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Atmospheric pressure; Biological and medical sciences; Biomechanical Phenomena; Collagen; Critical Care; Emergency and intensive respiratory care; Esophagus; Extracellular matrix; Female; Functional Residual Capacity - physiology; Humans; Intensive care medicine; Lung Compliance - physiology; Lungs; Male; Mathematical Computing; Medical sciences; Middle Aged; Patients; Positive-Pressure Respiration - adverse effects; Positive-Pressure Respiration - methods; Postoperative Complications - etiology; Postoperative Complications - physiopathology; Postoperative Complications - therapy; Pulmonary Ventilation - physiology; Reference Values; Respiratory distress syndrome; Respiratory Distress Syndrome, Adult - etiology; Respiratory Distress Syndrome, Adult - physiopathology; Respiratory Distress Syndrome, Adult - therapy; Respiratory Mechanics - physiology; Surgery; Thoracic Wall - physiopathology; Tidal Volume - physiology; Ventilators; Lung disease; Ventilator; Intensive care; acute respiratory distress syndrome; acute lung injury; stress; Respiratory disease; Mechanical stress; mechanical; strain; ventilator-induced lung injury; Respiratory distress; Mechanical ventilation; Resuscitation; Stress

Lung injury caused by a ventilator results from nonphysiologic lung stress (transpulmonary pressure) and strain (inflated volume to functional residual capacity ratio). To determine whether plateau pressure and tidal volume are adequate surrogates for stress and strain, and to quantify the stress to...