Time Course of Evolving Ventilator-Induced Lung Injury: The "Shrinking Baby Lung"

From Critical Care Medicine. 

This paper introduces and highlights several important and /or novel concepts seldom considered by the practicing intensivist.

These include: the increased vulnerability of the ‘baby lung’ of ARDS (the ‘shrinking baby lung’), the likelihood of a self-amplifying (positive feedback) injury cycle when the application of excessive specific power is ignored (the 'VILI vortex'), mechanisms of catastrophic barrier breakdown and resilience, evolving VILI risk with duration of exposure, and the implication of considering power in conjunction with threshold pressure (rather than pressure or power individually) in VILI generation and avoidance.

John J. Marini, MD  
Luciano Gattinoni, MD

Estimated Time: 23:16 min