Erschienen in:
01.08.2003 | Editorial
Ventilator-induced lung injury, cytokines, PEEP, and mortality: implications for practice and for clinical trials
verfasst von:
Arthur S. Slutsky, Yumiko Imai
Erschienen in:
Intensive Care Medicine
|
Ausgabe 8/2003
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Excerpt
A mainstay in the supportive care of patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is mechanical ventilation. However, a number of animal and clinical studies have demonstrated that mechanical ventilation itself can worsen preexisting lung injury and produce ventilator-induced lung injury (VILI). Although the most obvious clinical abnormalities of ALI/ARDS are related to lung function, the most common cause of death is dysfunction of other organs, termed multiple organ dysfunction syndrome (MODS) [
1], which is commonly accompanied by the systemic inflammatory response syndrome (SIRS). SIRS/MODS is a complex syndrome, often precipitated and intensified by a series of events rather than a single event. Recent clinical trials have demonstrated that in patients with ARDS, protective ventilatory strategies are associated with decreased serum cytokine levels [
2,
3], decreased levels of organ dysfunction [
3,
4], and decreased mortality [
3,
5], perhaps by partially mitigating the development of MODS [
6]. …
