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Mechanical Ventilation. Biophysical Injury. Biochemical Injury ( Biotrauma ). shear overdistention cyclic stretch D intrathoracic pressure. Epithelium/ interstitium. cytokines, complement, PGs, LTs, ROS,proteases. MΦ. alveolar-capillary permeability.
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Mechanical Ventilation Biophysical Injury Biochemical Injury (Biotrauma) • shear • overdistention • cyclic stretch • Dintrathoracic • pressure Epithelium/ interstitium cytokines, complement, PGs, LTs, ROS,proteases MΦ • alveolar-capillary permeability • cardiac output • organ perfusion DEATH Multiple Organ Dysfunction • NAVA • Targeting Transpulmonary Pressure • ECLS • Anti-Cytokine Therapy • Heat Shock Response neutrophils