Evolving concepts for safer ventilation

JJ Marini - Critical Care, 2019 - Springer
Our current understanding of protective measures for avoiding ventilator-induced lung injury
(VILI) has evolved from targeting low tidal volumes to lowering plateau and driving pressure …

Static and dynamic contributors to ventilator-induced lung injury in clinical practice. Pressure, energy, and power

JJ Marini, PRM Rocco, L Gattinoni - American journal of respiratory …, 2020 - atsjournals.org
Ventilation is inherently a dynamic process. The present-day clinical practice of
concentrating on the static inflation characteristics of the individual tidal cycle (plateau …

Lung stress, strain, and energy load: engineering concepts to understand the mechanism of ventilator-induced lung injury (VILI)

GF Nieman, J Satalin, P Andrews, NM Habashi… - Intensive care medicine …, 2016 - Springer
It was recently shown that acute respiratory distress syndrome (ARDS) mortality has not
been reduced in over 15 years and remains~ 40%, even with protective low tidal volume …

Practical assessment of risk of VILI from ventilating power: a conceptual model

JJ Marini, LT Thornton, PRM Rocco, L Gattinoni… - Critical Care, 2023 - Springer
At the bedside, assessing the risk of ventilator-induced lung injury (VILI) requires parameters
readily measured by the clinician. For this purpose, driving pressure (DP) and end …

[HTML][HTML] Understanding the mechanisms of ventilator-induced lung injury using animal models

PL Silva, M Scharffenberg, PRM Rocco - Intensive Care Medicine …, 2023 - Springer
Mechanical ventilation is a life-saving therapy in several clinical situations, promoting gas
exchange and providing rest to the respiratory muscles. However, mechanical ventilation …

Dynamic predictors of VILI risk: beyond the driving pressure

JJ Marini, S Jaber - Intensive care medicine, 2016 - Springer
As currently implemented, lung protective ventilation concentrates on certain static
characteristics of the individual tidal cycle—tidal volume (TV), plateau pressure, PEEP, and …

Biotrauma and ventilator-induced lung injury: clinical implications

GF Curley, JG Laffey, H Zhang, AS Slutsky - Chest, 2016 - Elsevier
The pathophysiological mechanisms by which mechanical ventilation can contribute to lung
injury, termed “ventilator-induced lung injury”(VILI), is increasingly well understood.“ …

Novel approaches to minimize ventilator-induced lung injury

E Fan, J Villar, AS Slutsky - BMC medicine, 2013 - Springer
Despite over 40 years of research, there is no specific lung-directed therapy for the acute
respiratory distress syndrome (ARDS). Although much has evolved in our understanding of …

Which component of mechanical power is most important in causing VILI?

JJ Marini, PRM Rocco - Critical Care, 2020 - Springer
Repeated applications of tidal energy inflict lung damage (VILI) when stress and strain
exceed the limits of tissue tolerance. Inflation work and energy are the products of pressure …

The POOR Get POORer: a hypothesis for the pathogenesis of ventilator-induced lung injury

DP Gaver III, GF Nieman, LA Gatto… - American journal of …, 2020 - atsjournals.org
Protective ventilation strategies for the injured lung currently revolve around the use of low
Vt, ostensibly to avoid volutrauma, together with positive end-expiratory pressure to increase …