Preventing ventilator-induced lung injury—what does the evidence say?

Hoegl, Sandra; Zwißler, Bernhard

doi:10.21037/jtd.2017.06.135

Cited by 4 publications

(6 citation statements)

References 26 publications

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“…As the search for an effective therapy against COVID-19 continues, attention should equally be focused on other modifiable factors that could increase the risk of pulmonary fibrosis. The risk of ventilator-induced lung injury should be minimized by the use of protective lung ventilation settings with low tidal volumes and low inspiratory pressures [113]. This has been shown to reduce the relative risk of mortality in ARDS by 30% [113].…”

Section: Strategies For Reducing the Risk Of Sars-cov-2 Infection-assmentioning

confidence: 99%

“…The risk of ventilator-induced lung injury should be minimized by the use of protective lung ventilation settings with low tidal volumes and low inspiratory pressures [113]. This has been shown to reduce the relative risk of mortality in ARDS by 30% [113]. In addition, continuous lung injury has been considered a major factor in the development of lung fibrosis.…”

Section: Strategies For Reducing the Risk Of Sars-cov-2 Infection-assmentioning

confidence: 99%

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Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies

et al. 2020

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Although pulmonary fibrosis can occur in the absence of a clear-cut inciting agent, and without a clinically clear initial acute inflammatory phase, it is more commonly associated with severe lung injury. This may be due to respiratory infections, chronic granulomatous diseases, medications, and connective tissue disorders. Pulmonary fibrosis is associated with permanent pulmonary architectural distortion and irreversible lung dysfunction. Available clinical, radiographic, and autopsy data has indicated that pulmonary fibrosis is central to severe acute respiratory distress syndrome (SARS) and MERS pathology, and current evidence suggests that pulmonary fibrosis could also complicate infection by SARS-CoV-2. The aim of this review is to explore the current literature on the pathogenesis of lung injury in COVID-19 infection. We evaluate the evidence in support of the putative risk factors for the development of lung fibrosis in the disease and propose risk mitigation strategies. We conclude that, from the available literature, the predictors of pulmonary fibrosis in COVID-19 infection are advanced age, illness severity, length of ICU stay and mechanical ventilation, smoking and chronic alcoholism. With no proven effective targeted therapy against pulmonary fibrosis, risk reduction measures should be directed at limiting the severity of the disease and protecting the lungs from other incidental injuries.

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Section: Strategies For Reducing the Risk Of Sars-cov-2 Infection-assmentioning

confidence: 99%

Section: Strategies For Reducing the Risk Of Sars-cov-2 Infection-assmentioning

confidence: 99%

Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies

et al. 2020

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“…Ppeak, peak inspiratory pressure; Cdyn, dynamic compliance; PaO 2 , arterial oxygen tension; PaCO 2 , arterial carbon dioxide tension; HR, heart rate; MAP, mean arterial pressure; CVP, central venous pressure; CO, cardiac output. (5,15,16,18). So LPV was used for CHD patients undergoing lung resection during OLV in this study.…”

Section: Discussionmentioning

confidence: 99%

“…But use of very low levels of PEEP could lead to atelectasis with ventilation strategies that incorporate lower Vt. High PEEP could cause lung overdistension and circulatory compromise (16). Previous studies have demonstrated that LPV with small Vt and appropriate PEEP reduced lung inflammation (17,18). However, it is not clear whether the reduction of inflammatory cytokines can effectively prevent the lung injury during the lung cancer resection OLV period of CHD patients.…”

Section: Introductionmentioning

confidence: 99%

Effect of lung protective ventilation on coronary heart disease patients undergoing lung cancer resection

et al. 2018

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“…low tidal volume, high positive end-expiratory pressure) maybe not enough to minimize ventilator-induced lung injury [2]. Thus, individualized ventilation strategies are essential for lung protection [3][4][5]. Unfortunately, few techniques are available for real-time monitoring and understanding of the respiratory system [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

A Wireless, Low-Power, and Miniaturized EIT System for Remote and Long-Term Monitoring of Lung Ventilation in the Isolation Ward of ICU

Yang

Dai

Wang

et al. 2021

IEEE Trans. Instrum. Meas.

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Individualized lung-protective ventilation strategy is essential for patients with COVID-19. In this study, a wireless, low-power and miniaturized electrical impedance tomography (EIT) system was developed for remote and long-term monitoring of lung ventilation for patients with COVID-19 in the isolation ward of ICU. A new strategy of combining filtering and improved voltage-controlled current was employed to design the current source for a simplified system structure, and a new differential receiver circuit consisting of a buffer amplification and a differential amplification was proposed to design the voltage measurement unit for high precision. Moreover, a Bluetooth interface was adopted for wireless data transmission, and components characterized by low power consumption were selected to minimize the system power consumption. The proposed EIT system occupies a total size of 6.5*4.5*0.6 cm 3 and can work stably within 25 m from the wireless terminal installed with host EIT software. The system has a signal-to-noise of 70 dB at 50 kHz, stability of 0.1% relative change, and power consumption of 114 mW, as tested with a resistor phantom. Further, a comparison between the proposed system and a commercial ICU EIT device was conducted on nine healthy volunteers for ventilation monitoring. The correlation between lung volume and relative impedance changes was higher than 0.9 for both EIT systems (p<0.001). The analysis of the corresponding EIT images revealed that both systems delivered comparable images in terms of linearity, repeatability and regional ventilation distribution. The test and experimental results suggested that the proposed system could conveniently provide reliable data acquisition for remote and long-term lung ventilation monitoring.

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Preventing ventilator-induced lung injury—what does the evidence say?

Cited by 4 publications

References 26 publications

Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies

Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies

Effect of lung protective ventilation on coronary heart disease patients undergoing lung cancer resection

A Wireless, Low-Power, and Miniaturized EIT System for Remote and Long-Term Monitoring of Lung Ventilation in the Isolation Ward of ICU

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