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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 Nov 17

DOI: 10.23736/S0375-9393.17.12205-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Ventilator-induced lung injury: does it occur in children?

Martin C. KNEYBER 1, 2

1 Division of Paediatric Critical Care Medicine, Department of Paediatrics, Beatrix Children's Hospital Groningen, University Medical Center Groningen, The University of Groningen, Groningen, The Netherlands; 2 Critical Care, Anaesthesiology, Peri-operative and Emergency Medicine (CAPE), The University of Groningen, Groningen, The Netherlands


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Mechanical ventilation is one of the most practiced interventions in the paediatric intensive care unit (PICU). Although unmistakable life-saving, it can also injury the lung, a process coined ventilator induced lung injury (VILI). To date, almost all of our knowledge VILI has been obtained from studies in adults or experimental studies mimicking the adult critical care situation. This leaves the question if VILI is of importance in the paediatric context. Paediatric clinical studies did not confirm an association between large tidal volume (Vt) and adverse outcome. In fact, the opposite has been shown. These same studies did show an association between high pressures and adverse outcome. Experimental data showed that the use of large, supraphysiologic Vt resulted in less inflammation and injury in paediatric animal models compared to adult models, suggesting an age-related susceptibility to VILI. However, the question whether or not there is an age-related susceptibility to VILI remains puzzling and unanswered. It is remarkable that one of the most practiced interventions such as paediatric MV is hardly supported by any scientific evidence but rather based on personal experience and data from adults. This signifies the need for clinical and experimental studies in order to better understand the use and effects of MV in paediatric patients with or without lung injury.


KEY WORDS: Mechanical ventilation - Ventilator-induced lung injury - Children - Clinical studies - Experimental studies

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Publication History

Article first published online: November 17, 2017
Manuscript accepted: November 14, 2017
Manuscript revised: October 12, 2017
Manuscript received: May 29, 2017

Cite this article as

Kneyber MC. Ventilator-induced lung injury: does it occur in children? Minerva Anestesiol 2017 Nov 17. DOI: 10.23736/S0375-9393.17.12205-4

Corresponding author e-mail

m.c.j.kneyber@umcg.nl