Atelektotrauma

Atelektotrauma je povreda pluća povezana sa ponovljenim otvaranjem i zatvaranjem (aktiviranjem i kolapsom) oštećenih alveola pluća tokom mehaničke ventilacije.^[1]

Etiopatogeneza

Mehanička ventilacija pri malim (apsolutnim) zapreminama pluća može da izazove povredu pluća kroz više mehanizama, kao što su:

ponavljajuće otvaranje i zatvaranje disajnih puteva i plućnih jedinica.^[2]^[3]
efekti na funkciju surfaktanta,^[4]
regionalna hipoksija.

U ovim slučajevima nastaje karakteristična povreda pluća sa ljuštenjem epitela, stvarnjem hijalinske membrane i plućnog edema koja je nazvana „atelektrauma“.^[2]

Atelektrauma je pojačana u plućima, u kojima postoje izražene homogenosti u ventilaciji.^[5] Od pre mnogo decenija, pokazano je da sile istezanja u plućnom parenhima na marginama između aeriranih i atelektatskih regiona mogu biti i do četiri do pet puta veće od onih u drugim plućnim regionima.^[6]

Izvori

^ Carrasco Loza, R; Villamizar Rodríguez, G; Medel Fernández, N (2015-06-26). „Ventilator-Induced Lung Injury (VILI) in Acute Respiratory Distress Syndrome (ARDS): Volutrauma and Molecular Effects”. The Open Respiratory Medicine Journal. 9: 112—119. ISSN 1874-3064. PMC 4541417 . PMID 26312103. doi:10.2174/1874306401509010112.
^ ^a ^b Slutsky, Arthur S. (1999). „Lung Injury Caused by Mechanical Ventilation”. Chest. 116: 9S—15S. ISSN 0012-3692. doi:10.1378/chest.116.suppl_1.9s-a.
^ Bilek, Anastacia M.; Dee, Kay C.; Gaver, Donald P. (2003-02-01). „Mechanisms of surface-tension-induced epithelial cell damage in a model of pulmonary airway reopening”. Journal of Applied Physiology. 94 (2): 770—783. ISSN 8750-7587. doi:10.1152/japplphysiol.00764.2002.
^ lbert, R. K. (2012). „The role of ventilation-induced surfactant dysfunction and atelectasis in causing acute respiratory distress syndrome.”. American Journal of Respiratory and Critical Care Medicine. 185: 702—8. .
^ Slutsky, Arthur S.; Ranieri, V. Marco (2013-11-28). „Ventilator-Induced Lung Injury”. New England Journal of Medicine. 369 (22): 2126—2136. ISSN 0028-4793. doi:10.1056/nejmra1208707.
^ Mead, J; Takishima, T; Leith, D (1970). „Stress distribution in lungs: a model of pulmonary elasticity.”. Journal of Applied Physiology. 28 (5): 596—608. ISSN 8750-7587. doi:10.1152/jappl.1970.28.5.596.

Spoljašnje veze

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[1] Carrasco Loza, R; Villamizar Rodríguez, G; Medel Fernández, N (2015-06-26). „Ventilator-Induced Lung Injury (VILI) in Acute Respiratory Distress Syndrome (ARDS): Volutrauma and Molecular Effects”. The Open Respiratory Medicine Journal. 9: 112—119. ISSN 1874-3064. PMC 4541417 . PMID 26312103. doi:10.2174/1874306401509010112.

[:0-2] Slutsky, Arthur S. (1999). „Lung Injury Caused by Mechanical Ventilation”. Chest. 116: 9S—15S. ISSN 0012-3692. doi:10.1378/chest.116.suppl_1.9s-a.

[3] Bilek, Anastacia M.; Dee, Kay C.; Gaver, Donald P. (2003-02-01). „Mechanisms of surface-tension-induced epithelial cell damage in a model of pulmonary airway reopening”. Journal of Applied Physiology. 94 (2): 770—783. ISSN 8750-7587. doi:10.1152/japplphysiol.00764.2002.

[4] rt, R. K. (2012). „The role of ventilation-induced surfactant dysfunction and atelectasis in causing acute respiratory distress syndrome.”. American Journal of Respiratory and Critical Care Medicine. 185: 702—8. .

[5] Slutsky, Arthur S.; Ranieri, V. Marco (2013-11-28). „Ventilator-Induced Lung Injury”. New England Journal of Medicine. 369 (22): 2126—2136. ISSN 0028-4793. doi:10.1056/nejmra1208707.

[6] Mead, J; Takishima, T; Leith, D (1970). „Stress distribution in lungs: a model of pulmonary elasticity.”. Journal of Applied Physiology. 28 (5): 596—608. ISSN 8750-7587. doi:10.1152/jappl.1970.28.5.596.

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