Barotrauma, Volume Trauma and Their Relation to FRC

  • L. Tremblay
  • A. S. Slutsky


The term barotrauma (pressure induced injury) is often used in reference to complications of mechanical ventilation involving extravasation of air from the lung (e.g., pulmonary interstitial emphysema, pneumomediastinum, subcutaneous emphysema, pneumothorax). Macklin et al. proposed that high ventilatory pressures disrupt the respiratory epithelium at the interface between the alveolar base and the vascular sheath, thereby allowing air to track along the bronchoalveolar sheaths and dissect (or break free) into the interstitial, vascular, mediastinal, peritoneal, retroperitoneal, pleural or subcutaneous spaces [1]. A number of studies have supported an association between barotrauma and high peak airway pressures, PEEP, tidal volumes, or minute ventilation [2, 3]. However, a recent prospective multivariate analysis of patients receiving mechanical ventilation for greater than 24 hours found only the presence of ARDS to correlate independently with the risk of developing pneumothorax [4]. Thus, it is possible that the association of air leaks with high ventilatory pressures noted in prior studies was a reflection of the severity of underlying lung injury (necessitating use of high pressures for ventilation), rather than an effect of the high ventilatory pressures causing the barotrauma.


Lung Injury Tidal Volume Lung Volume Peak Inspiratory Pressure Large Tidal Volume 


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Copyright information

© Springer-Verlag Italia, Milano 1998

Authors and Affiliations

  • L. Tremblay
  • A. S. Slutsky

There are no affiliations available

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