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Review

Bench-to-bedside review: Microvascular and airspace linkage in ventilator-induced lung injury

John J Marini1*, John R Hotchkiss2 and Alain F Broccard3

Author Affiliations

1 Professor, University of Minnesota, Regions Hospital, St Paul, Minnesota, USA

2 Assistant Professor, University of Minnesota, Regions Hospital, St Paul, Minnesota, USA

3 Associate Professor, University of Minnesota, Regions Hospital, St Paul, Minnesota, USA

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Critical Care 2003, 7:435-444 doi:10.1186/cc2392

Published: 17 October 2003

Abstract

Experimental and clinical evidence point strongly toward the potential for microvascular stresses to influence the severity and expression of ventilator associated lung injury. Intense microvascular stresses not only influence edema but predispose to structural failure of the gas–blood barrier, possibly with adverse consequences for the lung and for extrapulmonary organs. Taking measures to lower vascular stress may offer a logical, but as yet unproven, extension of a lung-protective strategy for life support in ARDS.

Keywords:
acute respiratory distress syndrome; capillary stress fracture; mechanical ventilation; vascular injury; ventilator-induced lung injury