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Alveolar Recruitment in Patients with Assisted Ventilation: Open Up the Lung in Spontaneous Breathing

  • A. Lovas
  • Z. Molnár
Chapter
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)

Introduction

Hypoxemic respiratory failure, especially its most severe form, acute respiratory distress syndrome (ARDS), is one of the leading reasons for implementing mechanical ventilation in the critically ill [1]. ARDS is a life‐threatening condition precipitated by disorders that frequently result in intensive care unit (ICU) admission. All of these disorders causing either direct pulmonary or indirect extrapulmonary tissue damage feature a systemic inflammatory response. Released cytokines, such as interleukin (IL)‐1, IL‐6, IL‐8 and tumor necrosis factor (TNF), activate neutrophils in the lung throughout the inflammatory cascade [2]. Thereafter, injurious substances, such as free oxygen radicals and proteolytic enzymes, are secreted by the activated immune cells leading to alveolar endothelium and epithelium destruction. The latter pathophysiological mechanism induces impaired permeability in the lung resulting in alveolar flooding by protein‐rich edema fluid [3]. Surfactant,...

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© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Anesthesiology and Intensive CareUniversity of SzegedSzegedHungary

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