Journal
RESPIRATORY PHYSIOLOGY & NEUROBIOLOGY
Volume 163, Issue 1-3, Pages 44-53Publisher
ELSEVIER
DOI: 10.1016/j.resp.2008.06.019
Keywords
Acute lung injury; Mechanical ventilation; Plasma membrane repair; Deformation-induced lipid trafficking; Osmotic stress
Categories
Funding
- NHLBI NIH HHS [R01 HL063178-09A1, R01 HL063178] Funding Source: Medline
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Acute lung injury (ALI) is a common, frequently hospital-acquired condition with a high morbidity and mortality. The stress associated with invasive mechanical ventilation represents a potentially harmful exposure, and attempts to minimize deforming stress through low tidal ventilation have proven efficacious. Lung cells are both sensors and transducers of deforming stress, and are frequently wounded in the setting of mechanical ventilation. Cell wounding may be one of the drivers of the innate immunologic and systemic inflammatory response associated with mechanical ventilation. These downstream effects of mechanotransduction have been referred to collectively as Biotrauma. Our review will focus on cellular stress failure, that is cell wounding, and the mechanisms mediating subsequent plasma membrane repair, we hold that a better mechanistic understanding of cell plasticity, deformation associated remodeling and repair will reveal candidate approaches for lung protective interventions in mechanically ventilated patients. We will detail one such intervention, lung conditioning with hypertonic solutions as an example of ongoing research in this arena. (C) 2008 Elsevier B.V. All rights reserved.
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