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Unshrinking the baby lung to calm the VILI vortex
Journal article   Open access   Peer reviewed

Unshrinking the baby lung to calm the VILI vortex

Gary Nieman, Michaela Kollisch-Singule, Harry Ramcharran, Joshua Satalin, Sarah Blair, Louis A. Gatto, Penny Andrews, Auyon Ghosh, David W. Kaczka, Donald Gaver, …
Critical care (London, England), Vol.26(1), pp.1-14
08/01/2022
DOI: 10.1186/s13054-022-04105-x
PMCID: PMC9357329
PMID: 35934707
url
https://doi.org/10.1186/s13054-022-04105-xView
Published (Version of record) Open Access

Abstract

Abstract A hallmark of ARDS is progressive shrinking of the ‘baby lung,’ now referred to as the ventilator-induced lung injury (VILI) ‘vortex.’ Reducing the risk of the VILI vortex is the goal of current ventilation strategies; unfortunately, this goal has not been achieved nor has mortality been reduced. However, the temporal aspects of a mechanical breath have not been considered. A brief expiration prevents alveolar collapse, and an extended inspiration can recruit the atelectatic lung over hours. Time-controlled adaptive ventilation (TCAV) is a novel ventilator approach to achieve these goals, since it considers many of the temporal aspects of dynamic lung mechanics.
Acute respiratory distress syndrome (ARDS) Protective mechanical ventilation Ventilator-induced lung injury (VILI)

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