Ventilator-Associated Lung Injury: Pathophysiology, Prevention, and Emerging Therapeutic Strategies

Area of Science:

• Critical care medicine
• Pulmonary medicine
• Biomedical engineering

Background:

• Mechanical ventilation is essential for patients with inadequate oxygenation or CO2 removal.
• Mechanical ventilation can cause lung injury (volutrauma, barotrauma, atelectrauma, biotrauma) and exacerbate conditions like acute respiratory distress syndrome.
• Ventilator-associated lung injury (VALI) can initiate systemic inflammation, leading to multi-organ failure.

Purpose of the Study:

• To review the pathophysiology, systemic effects, and risk factors of ventilator-associated lung injury (VALI).
• To discuss clinical presentation, diagnosis, and current protective ventilation strategies.
• To explore emerging therapies and interdisciplinary approaches for VALI prevention.

Main Methods:

• Comprehensive literature review of pathophysiology, clinical aspects, and therapeutic strategies for VALI.
• Integration of interdisciplinary research, including cellular and molecular responses.
• Examination of novel pharmacologic, stem-cell, artificial intelligence, and machine learning approaches.

Main Results:

• Mechanical ventilation, while life-saving, poses risks of lung injury and systemic inflammation.
• Lung-protective ventilation strategies are crucial for minimizing VALI and improving patient outcomes.
• Emerging therapies and advanced technologies offer new frameworks for VALI prevention.

Conclusions:

• Understanding VALI pathophysiology is key to developing effective prevention and treatment strategies.
• A multidisciplinary approach integrating mechanical considerations with novel therapies is essential.
• Future directions include leveraging AI and machine learning for personalized VALI prevention.