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Updated: Jun 18, 2025
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A Model of Self-limited Acute Lung Injury by Unilateral Intra-bronchial Acid Instillation
Published on: August 30, 2019
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Clinical and Experimental Evidence for Patient Self-Inflicted Lung Injury (P-SILI) and Bedside Monitoring
Ines Marongiu1, Douglas Slobod2, Marco Leali3
1Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Journal of Clinical Medicine
|July 27, 2024
Summary
Patient self-inflicted lung injury (P-SILI) can worsen outcomes in acute respiratory distress syndrome (ARDS) patients. Recognizing high inspiratory effort is crucial for preventing further lung damage and improving mortality rates.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Respiratory Physiology
Background:
- Spontaneous breathing offers benefits in Acute Respiratory Distress Syndrome (ARDS).
- However, excessive inspiratory effort can cause Patient self-inflicted lung injury (P-SILI).
- Assessing this risk is vital to prevent delayed intubation and reduce mortality.
Purpose of the Study:
- To review evidence on lung injury from high inspiratory effort.
- To discuss the mechanisms of P-SILI.
- To explore bedside measures for detecting increased respiratory drive.
Main Methods:
- Literature review of clinical and experimental studies.
- Analysis of pathophysiological mechanisms.
- Evaluation of physiological monitoring techniques.
Main Results:
- Evidence supports lung injury caused by uncontrolled high inspiratory effort.
- Increased respiratory drive can lead to P-SILI.
- Bedside physiological measures can identify increased respiratory drive.
Conclusions:
- Recognizing injurious respiratory patterns is key to preventing P-SILI.
- Early identification and management of high inspiratory effort can improve ARDS outcomes.
- This review provides insights for clinicians to manage P-SILI.
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