High oxygen concentrations: High levels of oxygen can cause inflammation and damage to the lungs, increasing the risk of VILI.High airway pressure: High airway pressure can cause damage to the lungs and increase the risk of VILI.Prolonged mechanical ventilation: Patients who are on a mechanical ventilator for an extended period of time are at a higher risk of developing VILI.Acute respiratory distress syndrome (ARDS): Patients with ARDS are at a higher risk of developing VILI because their lung tissue is already damaged and more susceptible to further injury.The risk factors for ventilator-induced lung injury (VILI) include: Additionally, some types of VILI can coexist with others, as well as with other lung diseases. It’s important to note that multiple mechanisms can act together in the same patient. Shear stress: This occurs when the lungs are exposed to high pressure gradients, leading to injury in the lung’s blood vessels and microcirculation.Oxygen toxicity: This occurs when the lungs are exposed to high oxygen concentrations, which can cause damage to lung tissue.This causes shear stress, which has damaging effects on the alveoli.
Atelectotrauma: This occurs when the alveoli are pulled apart from each other due to high airway pressures, or due to patients receiving high PEEP levels.Volutrauma: This occurs when the lungs are exposed to high tidal volumes (i.e., the amount of air delivered with each breath) and can lead to increased airway pressures and stretching of lung tissue.It can lead to a pneumothorax (i.e., collapsed lung) or pneumomediastinum (i.e., air in the space between the lungs and chest wall). Barotrauma: This occurs when the lungs are inflated beyond their compliance, causing damage to the alveoli and air spaces of the lungs.There are several different types of ventilator-induced lung injury (VILI) that can occur, depending on the specific mechanism of injury:
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