AUTHOR=Perlman Carrie E. 

TITLE=The Contribution of Surface Tension-Dependent Alveolar Septal Stress Concentrations to Ventilation-Induced Lung Injury in the Acute Respiratory Distress Syndrome

JOURNAL=Frontiers in Physiology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2020.00388

DOI=10.3389/fphys.2020.00388

ISSN=1664-042X

ABSTRACT=<p>In the acute respiratory distress syndrome (ARDS), surface tension, <italic>T</italic>, is likely elevated. And mechanical ventilation of ARDS patients causes ventilation-induced lung injury (VILI), which is believed to be proportional to <italic>T</italic>. However, the mechanisms through which elevated <italic>T</italic> may contribute to VILI have been under-studied. This conceptual analysis considers experimental and theoretical evidence for static and dynamic mechanical mechanisms, at the alveolar scale, through which elevated <italic>T</italic> exacerbates VILI; potential causes of elevated <italic>T</italic> in ARDS; and <italic>T</italic>-dependent means of reducing VILI. In the last section, possible means of reducing <italic>T</italic> and improving the efficacy of recruitment maneuvers during mechanical ventilation of ARDS patients are discussed.</p>