Mechanical ventilation-associated lung fibrosis in acute respiratory distress syndrome: mechanisms and new progress of treatment

Abstract

Background Mechanical ventilation plays a very important role in the treatment of acute respiratory distress syndrome(ARDS) patients. But inappropriate use of mechanical ventilation will induce or aggravate lung injury(ventilator-induced lung injury). More importantly, mechanical ventilation would significantly increase morbidity of pulmonary fibrosis and mortality in patients with ARDS. It is reported that the mortality of ARDS caused by uncontrollable pulmonary fibrosis ranges from 40% to 60%. Objective This article reviews the new progress of the mechanisms, prevention and treatment in mechanical ventilation-associated lung fibrosis. Content Mechanical stretch caused by mechanical ventilation, could activated cell signaling pathways, leading to the development of pulmonary fibrosis. Trend Pulmonary fibrosis caused by mechanical ventilation has become one of the important reasons for the poor prognosis and lung function decline in patients with ARDS. We should attach great importance to this problem, along with continuous exploration to its pathogenesis, so as to provide a better theoretical basis to develop effective prevention and control measures. Key words: Acute respiratory distress syndrome; Mechanical ventilation; Pulmonary fibrosis