chapter  7
48 Pages

The Significance of Air–Liquid Interfacial Stresses on Low-Volume Ventilator-Induced Lung Injury

WithDonald P. Gaver III, Anne-Marie Jacob, Anastacia M. Bilek, and Kay C Dee

In this chapter, we describe how pulmonary fluid-structure interactions,

lining fluid physics, and surfactant biophysical properties interrelate to influence the lung’s micromechanical environment during low-volume ven-

tilation. In conditions such as acute respiratory distress syndrome (ARDS)

and respiratory distress syndrome (RDS), the lining fluid and/or surfactant

systems may be abnormal, and the pulmonary tissue is particularly suscep-

tible to mechanical trauma. In these cases, low-volume ventilation strategies

may result in VILI. This chapter describes our present understanding of

the fluid-structure and physicochemical interactions that are related to

low-volume VILI, and potential techniques for reducing the likelihood or severity of this injury. For a more complete description of pulmonary lining

flows and their relationship to pulmonary disease, the reader is referred

to Ref. (1).