Objective：Mechanical ventilation （MV） has long been used as a life-sustaining approach for several decades.However,researchers realized that MV not only brings benefits to patients but also cause lung injury if use...Objective：Mechanical ventilation （MV） has long been used as a life-sustaining approach for several decades.However,researchers realized that MV not only brings benefits to patients but also cause lung injury if used improperly,which is termed as ventilator-induced lung injury （VILI）.This review aimed to discuss the pathogenesis of VILI and the underlying molecular mechanisms.Data Sources：This review was based on articles in the PubMed database up to December 2017 using the following keywords：＂ventilator-induced lung injury＂,＂pathogenesis＂,＂mechanism＂,and ＂biotrauma＂.Study Selection：Original articles and reviews pertaining to mechanisms of VILI were included and reviewed.Results：The pathogenesis of VILI was defined gradually,from traditional pathological mechanisms （barotrauma,volutrauma,and atelectrauma） to biotrauma.High airway pressure and transpulmonary pressure or cyclic opening and collapse of alveoli were thought to be the mechanisms of barotraumas,volutrauma,and atelectrauma.In the past two decades,accumulating evidence have addressed the importance of biotrauma during VILI,the molecular mechanism underlying biotrauma included but not limited to proinflammatory cytokines release,reactive oxygen species production,complement activation as well as mechanotransduction.Conclusions：Barotrauma,volutrauma,atelectrauma,and biotrauma contribute to VILI,and the molecular mechanisms are being clarified gradually.More studies are warranted to figure out how to minimize lung injury induced by MV.展开更多
目的观察乌司他丁对呼吸机所致肺损伤大鼠体内炎性因子的影响。方法24只SD大鼠随机分为对照组、大潮气量通气组和乌司他丁处理组,每组8只。大潮气量通气组和乌司他丁处理组接受机械通气,通气参数均设为:潮气量30 m l/kg,呼吸频率40次/m ...目的观察乌司他丁对呼吸机所致肺损伤大鼠体内炎性因子的影响。方法24只SD大鼠随机分为对照组、大潮气量通气组和乌司他丁处理组,每组8只。大潮气量通气组和乌司他丁处理组接受机械通气,通气参数均设为:潮气量30 m l/kg,呼吸频率40次/m in,吸呼比1∶3,吸入氧浓度21%。机械通气4 h后分别测定支气管肺泡灌洗液(BALF)中的蛋白含量、白细胞总数以及血清和BALF中肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)、IL-6和IL-10的水平。结果大潮气量通气组大鼠BALF中蛋白含量、白细胞总数以及血清和BALF中TNF-α、IL-1β、IL-6水平均显著高于对照组和乌司他丁处理组,但IL-10水平则显著降低。乌司他丁处理组与对照组比较上述指标差异无显著性。结论乌司他丁可以抑制大潮气量机械通气大鼠体内促炎因子的产生,对呼吸机所致的生物伤有预防作用。展开更多
基金This study was supported by grants from the National Natural Science Foundation of China （No. 81372036, No. 81671890, No. 81601669, and No. 81500064）.
文摘Objective：Mechanical ventilation （MV） has long been used as a life-sustaining approach for several decades.However,researchers realized that MV not only brings benefits to patients but also cause lung injury if used improperly,which is termed as ventilator-induced lung injury （VILI）.This review aimed to discuss the pathogenesis of VILI and the underlying molecular mechanisms.Data Sources：This review was based on articles in the PubMed database up to December 2017 using the following keywords：＂ventilator-induced lung injury＂,＂pathogenesis＂,＂mechanism＂,and ＂biotrauma＂.Study Selection：Original articles and reviews pertaining to mechanisms of VILI were included and reviewed.Results：The pathogenesis of VILI was defined gradually,from traditional pathological mechanisms （barotrauma,volutrauma,and atelectrauma） to biotrauma.High airway pressure and transpulmonary pressure or cyclic opening and collapse of alveoli were thought to be the mechanisms of barotraumas,volutrauma,and atelectrauma.In the past two decades,accumulating evidence have addressed the importance of biotrauma during VILI,the molecular mechanism underlying biotrauma included but not limited to proinflammatory cytokines release,reactive oxygen species production,complement activation as well as mechanotransduction.Conclusions：Barotrauma,volutrauma,atelectrauma,and biotrauma contribute to VILI,and the molecular mechanisms are being clarified gradually.More studies are warranted to figure out how to minimize lung injury induced by MV.
文摘目的观察乌司他丁对呼吸机所致肺损伤大鼠体内炎性因子的影响。方法24只SD大鼠随机分为对照组、大潮气量通气组和乌司他丁处理组,每组8只。大潮气量通气组和乌司他丁处理组接受机械通气,通气参数均设为:潮气量30 m l/kg,呼吸频率40次/m in,吸呼比1∶3,吸入氧浓度21%。机械通气4 h后分别测定支气管肺泡灌洗液(BALF)中的蛋白含量、白细胞总数以及血清和BALF中肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)、IL-6和IL-10的水平。结果大潮气量通气组大鼠BALF中蛋白含量、白细胞总数以及血清和BALF中TNF-α、IL-1β、IL-6水平均显著高于对照组和乌司他丁处理组,但IL-10水平则显著降低。乌司他丁处理组与对照组比较上述指标差异无显著性。结论乌司他丁可以抑制大潮气量机械通气大鼠体内促炎因子的产生,对呼吸机所致的生物伤有预防作用。
