Pathogenetic Significance of Biological Markers of Ventilator-Associated Lung Injury in Experimental and Clinical Studies

摘要

For patients with acute lung injury, positive pressure mechanical ventilation is life saving.nHowever, considerable experimental and clinical data have demonstrated that how clinicians setnthe tidal volume, positive end-expiratory pressure, and plateau airway pressure influences lungninjury severity and patient outcomes including mortality. In order to better identify ventilator-nassociated lung injury (VALI), clinical investigators have sought to measure blood-borne andnairspace biological markers of VALI. At the same time, several laboratory-based studies havenfocused on biological markers of inflammation and organ injury in experimental models in ordernto clarify the mechanisms of ventilator-induced lung injury (VILI) and VALI. This reviewnsummarizes data on biological markers of VALI and VILI from both clinical and experimentalnstudies with an emphasis on markers identified in patients and in the experimental setting. Thisnanalysis suggests that measurement of some of these biological markers may be of value inndiagnosing VALI and in understanding its pathogenesis. (CHEST 2006; 130:1906–1914)