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| Mechanisms of
ventilation-induced lung injury and its prevention: Role
of surfactant Serge JC Verbrugge & Burkhard Lachmann Mechanical ventilation has become an important and life-saving therapy in the treatment of premature neonates and patients with an impaired pulmonary function; in particular in patients with the acute respiratory distress syndrome (ARDS), which is characterized by acute respiratory failure and permeability changes of the alveolo-capillary membrane. However, already early after its introduction, it has become realized that certain modes of mechanical ventilation lead to decreases in lung compliance and gas exchange [1], and atelectasis, pulmonary edema, pneumonitis and fibrosis [2-6]. Therefore, the realization is growing, that much of the pathophysiological changes seen in ARDS, may be a consequence of our ventilatory interventions in combination with surfactant changes and surfactant changes due to mechanical ventilation, rather than the progression of the underlying disease. This paper addresses general aspects of pulmonary surfactant and more specifically focuses on interaction of surfactant abnormalities with mechanical ventilation. Keywords: Injury, surfactant, ventilation, mechanical Applied Cardiopulmonary Pathophysiology 7: 173-198, 1998 Prof. Dr. Dr. Burkhard Lachmann |
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