chapter  3
24 Pages

Response of Cellular Plasma Membrane to Mechanical Stress

WithRolf D. Hubmayr

Since the recognition of ventilator-induced lung injury (VILI) as a clinically

relevant entity, the effects of deforming stress on lung structure and function have been examined in literally hundreds of experimental studies

(1-4). In many instances, diverse morphologic and biologic sequelae of

deforming stress have been referred to under the single term ‘‘lung injury,’’

and a number of scoring systems have been devised to grade its severity

(5-8). However, as the appreciation for specific injury mechanisms has

grown, so has the realization that the lungs’ responses to injurious stress

can be quite nuanced and nonuniform with respect to space and time. In

fact, in 1998, Tremblay and Slutsky coined the term ‘‘biotrauma’’ to precisely underscore this point (9). Because it would be naive to assume that

the many distinct manifestations of biotrauma contain identical prognostic

or mechanistic information, it would seem prudent to differentiate between

specific pulmonary stress responses. After all, the term ‘‘injury’’ has been

used to describe biologic responses ranging from altered gene expressions,

protein synthesis and release, abnormal respiratory mechanics, inefficient

gas exchange, and impaired vascular barrier properties to the remodeling of lung structures and scar formation.