Role of microvasculature in the development of acute lung injury induced by mechanical ventilation

Pulmonary wedge pressure is one of the determinants of pulmonary edema and in addition favors the development of pulmonary injury induced by mechanical ventilation (PIMV). Accordingly, in the critically ill patients subject to mechanical ventilation (MV), the precise determination of pulmonary wedge pressure gain in importance. Vascular flow is also a decisive factor in acute pulmonary injury, and its increase favors a more intense pulmonary injury. The increase of these physiological variables determines an increment in mechanical stress on the cells of pulmonary capillary endothelium, and this stress can induce an endothelial inflammatory response with appearance or worsening of acute pulmonary injury. Accordingly, reducing pulmonary vascular stress can diminish acute lung injury in experimental models.