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Inflection Point and Alveolar Recruitment in ARDS

  • Conference paper
Yearbook of Intensive Care and Emergency Medicine 1997

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1997))

Abstract

Hypoxia is a hallmark of acute respiratory distress syndrome (ARDS) [1] and a major therapeutic goal is to improve arterial oxygen content. The mechanism underlying hypoxia is true intrapulmonary shunt [2] due to non-ventilated, perfused alveoli with little contribution of ventilation-perfusion mismatching. The increase in inspiratory oxygen concentration is not enough to correct hypoxia (refractory hypoxia), and reopening closed lung units represents the only way to improve gas exchange. Three principal reasons account for alveolar exclusion from ventilation:

  1. 1)

    the filling of the air spaces by exudate, pseudomembranes, cellular debris and inflammatory cells as consequence of the structural damage of the alveolo-capillary unit;

  2. 2)

    the collapse of small airways as a consequence of reduced lung volume and loss of the lining surfactant [3]; and

  3. 3)

    atelectasis due to compression of dependent lung units by increased weight of the overlying edematous lung parenchyma [4] or high O2 concentrations [5].

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Authors
  1. M. Mergoni
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  2. A. Volpi
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  3. A. Rossi
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Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Clinical Director) (Clinical Director)

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Mergoni, M., Volpi, A., Rossi, A. (1997). Inflection Point and Alveolar Recruitment in ARDS. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1997. Yearbook of Intensive Care and Emergency Medicine, vol 1997. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-13450-4_46

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  • DOI: https://doi.org/10.1007/978-3-662-13450-4_46

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-13452-8

  • Online ISBN: 978-3-662-13450-4

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