Lesão pulmonar induzida por ventilação mecânica invasiva, mecanismos e danos no sistema respiratório : revisão integrativa

Abstract

The adjustment of mechanical ventilation parameters in a general way is associated with the occurrence of Ventilation-Induced Lung Injury (PIVL). The causes and mechanisms that form LPIV are multiple. The use of a protective ventilatory strategy is able to reduce mortality by 22-46% in patients with IVPL. The aim of the study is to explore the knowledge about the mechanisms and damage of Mechanical Ventilator-Induced Lung Injury. This is an integrative literature review, carried out in the following databases: Scientific Electronic Library Online (SciELO), US National Library of Medicine National Institutes of Health (PubMed) and Cochrane Library (Cochrane Library). Publications were identified in English by the Medical Subject Headings (MeSH) descriptors and in Portuguese by the Health Sciences Descriptors (DeCS). Descriptors were used, with the Boolean operators “and” and “or”. The selected descriptors were adapted to the PICO strategy, aiming at an organized and systematized construction for the development of the review. A total of nine articles make up this integrative review. The main mechanisms causing lung injury induced by mechanical ventilation are: Plateau pressure that exceeds 30 cmH2O ; Driving Pressure greater than 15cmH2O; tidal volume greater than 6ml/kg predicted weight; PEEP can generate overdistension or cyclic collapse; Cyclic energy transduction in the lungs for various reasons may also be related to LPIV.