Acute Lung Injury
Defending the Lung From Injury
Charlotta McMurphy
Respiratory Procedures 3
September 12, 2011
Acute lung injury and acute respiratory distress syndrome seem to be more common these days as people have surgery or simply a medical patient in seeing a doctor. As we study and are learning about ALI and ARDS it seems people have a much longer survival rate than years ago. The technology, doctors and scientists have improved the outcome for people who have ADRS and ALI. We continue to make advancement on new treatments, taking important steps on bettering technology, patients have a much better and longer survival rate. A lung injury could be from biotrauma, barotrauma, atelectrauma, volutrauma each of these types of injury may have serious consequences. ALI is respiratory failure with bilateral infiltrates on chest x-rays in the absence of left sided heart failure and acute hypoxemia. ARDS which is further progression of lung disease as evidenced by PaO2/FiO2 which is equal to or less than 200. Mechanical ventilation can be life saving or necessary with ALI and ARDS. The ventilation and oxygenation goals and strategies are recruitment of the alveoli, balancing oxygen delivery and consumption, assessment of patient-ventilator synchrony, monitoring pulmonary over distension and making sure your protect the lung from ongoing injury. Mechanical ventilation in the setting is to maintain a proper amount of oxygen to the tissues and organs of the body while making sure you minimize any further injury to the lung. Mechanical ventilation induces an inflammatory response which creates the possibility for secondary ventilator induced lung injury (VILI). There are four primary mechanisms in which the lung could be injured, including biotrauma, barotrauma, atelectrauma, and volutrauma. It is vital the understanding how these impacts by various ventilator approach to the prevention of secondary pulmonary damage. The low tidal volume delivery approach has become
Charlotta McMurphy
Respiratory Procedures 3
September 12, 2011
Acute lung injury and acute respiratory distress syndrome seem to be more common these days as people have surgery or simply a medical patient in seeing a doctor. As we study and are learning about ALI and ARDS it seems people have a much longer survival rate than years ago. The technology, doctors and scientists have improved the outcome for people who have ADRS and ALI. We continue to make advancement on new treatments, taking important steps on bettering technology, patients have a much better and longer survival rate. A lung injury could be from biotrauma, barotrauma, atelectrauma, volutrauma each of these types of injury may have serious consequences. ALI is respiratory failure with bilateral infiltrates on chest x-rays in the absence of left sided heart failure and acute hypoxemia. ARDS which is further progression of lung disease as evidenced by PaO2/FiO2 which is equal to or less than 200. Mechanical ventilation can be life saving or necessary with ALI and ARDS. The ventilation and oxygenation goals and strategies are recruitment of the alveoli, balancing oxygen delivery and consumption, assessment of patient-ventilator synchrony, monitoring pulmonary over distension and making sure your protect the lung from ongoing injury. Mechanical ventilation in the setting is to maintain a proper amount of oxygen to the tissues and organs of the body while making sure you minimize any further injury to the lung. Mechanical ventilation induces an inflammatory response which creates the possibility for secondary ventilator induced lung injury (VILI). There are four primary mechanisms in which the lung could be injured, including biotrauma, barotrauma, atelectrauma, and volutrauma. It is vital the understanding how these impacts by various ventilator approach to the prevention of secondary pulmonary damage. The low tidal volume delivery approach has become
References: Definding the Lung From Injury. Dr. Anthony Diez, RRT, David A.Turner, MD, Ira M. Cheifetz, MD, FCCM, FAARC Advance For Respiratory Care & Sleep Medicine, July 2011