Article Document Information Content Entity Continuant Continuant Entity Entity Review Generically Dependent Continuant 2025-05-07T20:46:39 RDF description of Propagation prevention: a complementary mechanism for "lung protective" ventilation in acute respiratory distress syndrome [review] - http://repository.healthpartners.com/individual/document-rn18980 12031 Lung Propagation prevention: a complementary mechanism for "lung protective" ventilation in acute respiratory distress syndrome [review] Respiration, Artificial 36 document-rn18980 Injuries 2022-02-21T22:48:57.408-06:00 18642 Adverse Effects Respiratory Tract Diseases Critical Care review 10.1097/CCM.0b013e31818f0e68 Critical Care Medicine public 12 <p>OBJECTIVE: To describe the clinical implications of an often neglected mechanism through which localized acute lung injury may be propagated and intensified. DATA EXTRACTION AND SYNTHESIS: Experimental and clinical evidence from the medical literature relevant to the airway propagation hypothesis and its consequences. CONCLUSIONS: The diffuse injury that characterizes acute respiratory distress syndrome is often considered a process that begins synchronously throughout the lung, mediated by inhaled or blood-borne noxious agents. Relatively little attention has been paid to possibility that inflammatory lung injury may also begin focally and propagate sequentially via the airway network, proceeding mouth-ward from distal to proximal. Were this true, modifications of ventilatory pattern and position aimed at geographic containment of the injury process could help prevent its generalization and limit disease severity. The purposes of this communication are to call attention to this seldom considered mechanism for extending lung injury that might further justify implementation of low tidal volume/high positive end-expiratory pressure ventilatory strategies for lung protection and to suggest additional therapeutic measures implied by this broadened conceptual paradigm.<p>