Side Effects of Mechanical Ventilation: Molecular Mechanisms

  • A. N. von Bethmann
  • S. Uhlig
Conference paper


Artificial mechanical ventilation is a double-edged sword. Although indispensable in order to maintain oxygenation in patients it can also cause iatrogenic lung damage and may even have detrimental consequences in organs other than the lung. For a long time, research on the side-effects of mechanical ventilation had focused on physical forces and their effect on lung integrity [1]. Recently, we [2, 3] and others [4] have started to investigate the molecular mechanisms of ventilation-induced lung damage. These new findings suggest that ventilation at high volumes can act as a pro-inflammatory stimulus resulting in pulmonary production of tumor necrosis factor (TNF), interleukin-6 (IL-6) and other mediators. Such pro-inflammatory mediators represent potential candidates of initiating or promoting lung injury. Moreover, their release into the circulation may lead to development of the systemic inflammatory response syndrome (SIRS). It should be noted that this could elicit inflammatory responses in the absence of any infection.


Lung Injury Systemic Inflammatory Response Syndrome Pulmonary Artery Pressure Respir Crit Positive Pressure Ventilation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Parker JC, Hernandez LA, Peevy KJ (1993) Mechanisms of ventilator-induced lung injury. Crit Care Med 21: 131–143PubMedCrossRefGoogle Scholar
  2. 2.
    von Bethmann AN, Brasch F, Niising R et al (1997) Hyperventilation induces release of cytokines from perfused mouse lung. Am J Respir Crit Care Med (in press)Google Scholar
  3. 3.
    von Bethmann AN, Brasch F, Müller K et al (1996) Prolonged hyperventilation is required for release of tumor necrosis factor a but not IL-6. Appl Cardiopulm Pathophysiol 6: 171–177Google Scholar
  4. 4.
    Tremblay L, Valenza F, Ribeiro SP et al (1997) Injurious ventilatory strategies increase cytokines and c-fos m-RNA expression in an isolated rat lung model. J Clin Invest 99: 944–952PubMedCrossRefGoogle Scholar
  5. 5.
    Hernandez, LA, Peevey KJ, Moise AM et al (1989) Chest wall restriction limits high airway pressure-induced lung injury in young rabbits. J Appl Physiol 66: 2364–2368PubMedGoogle Scholar
  6. 6.
    Bouhuys A (1969) Physiology and musical instruments. Nature 221: 1199–1204PubMedCrossRefGoogle Scholar
  7. 7.
    Guery BPH, Neviere R, Fialdes et al (1997) Mechanical ventilation regimen induces intestinal permeability changes in a rat model. Am J Respir Crit Care Med 155: A505Google Scholar
  8. 8.
    Wirtz HR, Dobbs LG (1990) Calcium mobilization and exocytosis after one mechanical stretch of lung epithelial cells. Science 250: 1266–1269PubMedCrossRefGoogle Scholar
  9. 9.
    Hubmayr RD, Limper AH, Burton SL et al (1997) Stretch causes IL-8 release from alveolar epithel in vitro. Am J Respir Crit Care Med 155: A500Google Scholar
  10. 10.
    Skinner SJ, Somervell CE, Olson DE (1992) The effects of mechanical stretching on fetal rat lung cell prostacyclin production. Prostaglandins 43: 413–433PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1998

Authors and Affiliations

  • A. N. von Bethmann
  • S. Uhlig

There are no affiliations available

Personalised recommendations