Ventilator-associated lung injury
Ventilator-associated lung injury | |
---|---|
Synonyms | VALI |
Pronounce | N/A |
Specialty | N/A |
Symptoms | Hypoxemia, dyspnea, tachypnea, respiratory distress |
Complications | Acute respiratory distress syndrome, barotrauma, volutrauma, atelectrauma, biotrauma |
Onset | During mechanical ventilation |
Duration | Variable, depending on underlying condition and management |
Types | N/A |
Causes | Mechanical ventilation |
Risks | High tidal volume, high positive end-expiratory pressure, prolonged ventilation |
Diagnosis | Clinical evaluation, chest X-ray, CT scan |
Differential diagnosis | Pneumonia, pulmonary edema, acute respiratory distress syndrome |
Prevention | Lung-protective ventilation strategies, low tidal volume ventilation |
Treatment | Adjusting ventilator settings, supportive care, treating underlying cause |
Medication | N/A |
Prognosis | Variable, depends on severity and management |
Frequency | Common in patients on mechanical ventilation |
Deaths | N/A |
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.
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