Dehnungsabhängige pulmonale Freisetzung von Stickstoffmonoxid (NO)

摘要

Ventilatory strategies influence the prognosis of patients with acute lung injury. Low tidal volume ventilation improves outcome in ARDS. Alveolar overdistension has been identified as a crucial pathogenetic mechanism in ventilator-induced lung injury. Tidal volume is commonly related to ideal body weight. Because lung injury is often inhomogenous and varies largely in its extent, a tidal volume taylored to calculated ideal body weight will not guarantee lung protection. There is no clinical marker to, indicate the extent of alveolar distension allowing individual adjustment of tidal volume. This paper summarizes our experimental evidence indicating mechanically induced release of nitric oxide. It reports results from rat alveolar type II cells subjected to different stretching patterns and from isolated rabbit lungs ventilated with different ventilation patterns.