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Invasive Mechanical Ventilation in the Pathogenesis of Bronchopulmonary Dysplasia

  • Lauren M. Ramos
  • Tanbir Najrana
  • Juan Sanchez-EstebanEmail author
Chapter
  • 984 Downloads
Part of the Respiratory Medicine book series (RM)

Abstract

Invasive mechanical ventilation is often necessary for preterm infants born with underdeveloped lungs. However, invasive mechanical ventilation can induce lung injury and cause bronchopulmonary dysplasia (BPD). BPD is a chronic lung disease characterized by alveolar hypoplasia and impaired pulmonary vascular development. Although the pathogenesis of BPD is multifactorial, injury caused by invasive mechanical ventilation plays a significant role. Overdistension of the lung can damage lung resident cells and disrupt the alveolar–capillary barrier with subsequent release of proinflammatory cytokines, increase in permeability, and influx of neutrophils and macrophages to the lung. In addition to inducing an inflammatory response, invasive mechanical ventilation can also have a negative impact on important signaling pathways regulating alveolar development, such as secondary septation, cell proliferation, differentiation, apoptosis, and vasculogenesis. The final result is alveolar simplification and abnormal vascular development observed in patients with BPD.

Keywords

Lung injury Mechanical injury Mechanical ventilation Bronchopulmonary dysplasia Ventilator-induced lung injury 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Lauren M. Ramos
    • 1
  • Tanbir Najrana
    • 1
  • Juan Sanchez-Esteban
    • 1
    Email author
  1. 1.Department of Pediatrics, Neonatal-Perinatal Medicine, Women and Infants Hospital of Rhode IslandThe Warren Alpert Medical School of Brown UniversityProvidenceUSA

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