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2019, Number 1

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Med Crit 2019; 33 (1)

Does limiting the distension pressure protect against lung injury acquired by mechanical ventilation (VALI)?

Hernández PAE, Castillo AJA, Salmerón GJD, Cruz ECN, Gómez GMN, Soriano OR

Language: Spanish
References: 24
Page: 38-44
PDF size: 142.65 Kb.


ABSTRACT

The increase in airway pressure causes injury in the alveolar membrane by proposing barotrauma as the cause of ventilator-acquired Lung Injury (VALI), this condition occurs frequently, which leads to a better understanding of the roles played by the mechanical ventilator settings, underlying lung pathophysiology and their interaction. In the last decade, the term pressure of distension (PD) has emerged, arising from the calculation of the pressure delta (ΔP = Vt/CRS). The PD represents the dynamic changes of the pressure that is generated in the airway in each ventilatory cycle. Although pulmonary protection measures are initially installed, there are several conditions that modify elastic properties, such as fluid resuscitation and positive fluid balance, aggregated infectious processes, etc. However, even if these protective measures are met, excessive pulmonary distention may occur, so PD monitoring may be a useful tool for systematically determining changes in pulmonary stiffness by establishing interventions. In the absence of assays using PD as a target when establishing the ventilator, it is suggested that it be used as a complement and not as a substitute for pulmonary protection parameters.


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