What are the relative roles of vascular and airspace pressures in ventilator-induced lung injury?
Because rigorous limitation of pulmonary vascular pressures significantly attenuated the damage in lungs exposed to a fixed ventilatory pattern, the work outlined above suggests that elevations in pulmonary vascular pressure arising from interactions between lung volume, pulmonary vascular resistance, and pulmonary vascular flow could worsen ventilator-associated lung injury. Our redirected attention toward the vascular side of the alveolar capillary barrier stimulated us to ask whether the mechanism by which pulmonary artery pressure is phasically increased can influence the severity of lung damage during exposure to high alveolar pressure. In other words, is periodic inflation a necessary component of the vascular injury that is incurred during VILI? Knowing that the frequency of ventilation is an important determinant of VILI, we reasoned that a lung exposed to pulsatile vascular pressure but not ventilated might experience significant injury, even without fluctuations in airway pre
