Effects of Artificial Ventilation on Surfactant Function
Since its introduction for clinical routine use more than 40 years ago, artificial ventilation has proven to be a life-saving method or therapy in intensive care. It has also remained a topic of much discussion and controversy because artificial ventilation involves a disturbance of normal cardiovascular and respiratory function (Price et al. 1954). That artificial ventilation can lead to decreased lung compliance and a dysfunction of gas exchange is well-known. Even more important is that ventilation by itself can lead to formation of atelectasis, pulmonary edema, pneumonitis, and fibrosis (for review see Tables 1 and 2). To date, no adequate explanation of the pathophysiological basis of all the changes due to artificial ventilation has been documented. However, there is evidence that some of them are induced by alterations to the surfactant system. These findings have stimulated ongoing extensive research in this area in an attempt to explain the side effects of artificial ventilation and to find improved methods of artificial ventilation in which these effects are minimized.
KeywordsContinuous Positive Airway Pressure Surfactant System Lamellar Body Artificial Ventilation Lung Mechanic
Unable to display preview. Download preview PDF.
- Benzer H (1969) Respiratorbeatmung und Oberflächenspannung in der Lunge. In: Frey R, Kern F, Mayrhofer O (eds) Anaesthesiologie und Wiederbelebung, 38. Springer, Berlin Heidelberg New YorkGoogle Scholar
- Gruenwald PA (1963) A numerical index of the stability of lung expansion. J Appl Physiol 18:665–667Google Scholar
- Guyton AC, Moffatt DS, Adair TA (1980) Role of alveolar surface tension in transepithelial movement of fluid. In: Robertson B, Van Golde LMG, Batenburg JJ (eds) Pulmonary surfactant. Elsevier, Amsterdam, pp 171–185Google Scholar
- Hildebran JN, Goerke J, Clements JA (1981) Surfactant release in excised rat lung is stimulated by air inflation. J Appl Physiol (Respir Environ Exercise Physiol) 51:905–910Google Scholar
- Lachmann B (1985) Possible function of bronchial surfactant. Eur J Respir Dis 67:49–61Google Scholar
- Lachmann B (1989) Surfactant replacement. Appl Cardiopulm Pathophysiol 3:3–11Google Scholar
- Mead J, Collier C (1959) Relation of volume history of lungs to respiratory mechanics in anesthetized dogs. J Appl Physiol 14:669–678Google Scholar
- Oyarzùn MJ, Clements JA (1977) Ventilatory and cholinergic control of pulmonary surfactant in the rabbit. J Appl Physiol (Respir Environ Exercise Physiol) 43:39–45Google Scholar
- Reinfenrath R (1983) Surfactant action in bronchial mucus. In: Cosmi EV, Scarpelli EM (eds) Pulmonary surfactant system. Elsevier, Amsterdam, pp 339–347Google Scholar
- Rensch H, von Seefeld H (1984) Surfactant-mucus interaction. In: Robertson B, van Golde LMG, Batenburg JJ (eds) Pulmonary surfactant. Elsevier, Amsterdam, pp 203–214Google Scholar
- Wollmer P, Evander E, Jonson B (1989a) Assessment of surfactant function by measurement of the pulmonary clearance of inhaled 99mTc-DTPA. In: Lachmann B (ed) Surfactant replacement therapy in neonatal and adult respiratory distress syndrome. Springer, Berlin Heidelberg New York; pp 66–76Google Scholar
- Wollmer P, Evander E, Jonson B, Lachmann B (1989b) Pulmonary clearance of inhaled 99mTc-DTPA and surfactant function: In: Ekelund L, Jonson B, Malm L (eds) Surfactant and the respiratory tract. Elsevier, Amsterdam, pp 97–102Google Scholar