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Journal of the Korean Society of Neonatology 2004;11(1):15-22.
Published online May 1, 2004.
Ventilator Induced Lung Injury (VILI) and Strategies to Minimize the Injury.
Moon Sung Park
Department of Pediatrics Ajou University College of Medicine, Suwon, Korea. drparkns@ajou.ac.kr
인공 환기요법 중 폐손상과 최소화를 위한 치료전략
Abstract
Mechanical ventilation is an indispensable tool for providing gas exchange in many neonatal diseases. Despite the many advances in respiratory technique for neonate during the last several decades, VILI remains a significant complication. Moreover, lung injury may lead to other organ dysfunction. Mechanisms of VILI include high airway pressure (barotruma), large gas volume (volutrauma), alveolar collapse and re-expansion (atelectrauma), and increased inflammation (biotruma). And the injury ranges from macroscopic airleaks to intracellular changes in protein phosphorylation signaling cascades and gene expression. Prevention of VILI while accomplishing the essential life-supporting roles of mechanical ventilation is very challenging. There has been suggesting many ventilatory strategies to minimize VILI but the safety and the efficacy depends more on operator's skill, experience and choice of strategy than on the special device.
Key Words: Ventilator-induced lung injury, Lung protective ventilation, Neonatal respiratory distress syndrome
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