Musch Guido
Department of Anesthesiology and Perioperative Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
Front Physiol. 2021 Dec 9;12:762688. doi: 10.3389/fphys.2021.762688. eCollection 2021.
This review focuses on the advances in the understanding of the pathophysiology of ventilator-induced and acute lung injury that have been afforded by technological development of imaging methods over the last decades. Examples of such advances include the establishment of regional lung mechanical strain as a determinant of ventilator-induced lung injury, the relationship between alveolar recruitment and overdistension, the regional vs. diffuse nature of pulmonary involvement in acute respiratory distress syndrome (ARDS), the identification of the physiological determinants of the response to recruitment interventions, and the pathophysiological significance of metabolic alterations in the acutely injured lung. Taken together, these advances portray multimodality imaging as the next frontier to both advance knowledge of the pathophysiology of these conditions and to tailor treatment to the individual patient's condition.
本综述聚焦于过去几十年成像方法的技术发展为理解呼吸机诱导性肺损伤和急性肺损伤的病理生理学所带来的进展。这些进展的例子包括确定局部肺机械应变是呼吸机诱导性肺损伤的决定因素、肺泡复张与过度扩张之间的关系、急性呼吸窘迫综合征（ARDS）中肺部受累的局部与弥漫性质、确定对复张干预反应的生理决定因素，以及急性损伤肺中代谢改变的病理生理学意义。总体而言，这些进展将多模态成像描绘为推进这些病症病理生理学知识以及根据个体患者情况定制治疗方案的下一个前沿领域。
