BACKGROUND: The baby lung concept originated as an offspring of computed tomography examinations which showed in most patients with acute lung injury/acute respiratory distress syndrome that the normally aerated tissue has the dimensions of the lung of a 5- to 6-year-old child (300-500 g aerated tissue). DISCUSSION: The respiratory system compliance is linearly related to the baby lung dimensions, suggesting that the acute respiratory distress syndrome lung is not stiff but instead small, with nearly normal intrinsic elasticity. Initially we taught that the baby lung is a distinct anatomical structure, in the nondependent lung regions. However, the density redistribution in prone position shows that the baby lung is a functional and not an anatomical concept. This provides a rational for gentle lung treatment and a background to explain concepts such as baro- and volutrauma. CONCLUSIONS: From a physiological perspective the baby lung helps to understand ventilator-induced lung injury. In this context, what appears dangerous is not the V(T)/kg ratio but instead the V(T)/baby lung ratio. The practical message is straightforward: the smaller the baby lung, the greater is the potential for unsafe mechanical ventilation.

The concept of baby lung / L. Gattinoni, A. Pesenti. - In: INTENSIVE CARE MEDICINE. - ISSN 0342-4642. - 31:6(2005 Jun), pp. 775-784.

The concept of baby lung

L. Gattinoni;A. Pesenti
2005

Abstract

BACKGROUND: The baby lung concept originated as an offspring of computed tomography examinations which showed in most patients with acute lung injury/acute respiratory distress syndrome that the normally aerated tissue has the dimensions of the lung of a 5- to 6-year-old child (300-500 g aerated tissue). DISCUSSION: The respiratory system compliance is linearly related to the baby lung dimensions, suggesting that the acute respiratory distress syndrome lung is not stiff but instead small, with nearly normal intrinsic elasticity. Initially we taught that the baby lung is a distinct anatomical structure, in the nondependent lung regions. However, the density redistribution in prone position shows that the baby lung is a functional and not an anatomical concept. This provides a rational for gentle lung treatment and a background to explain concepts such as baro- and volutrauma. CONCLUSIONS: From a physiological perspective the baby lung helps to understand ventilator-induced lung injury. In this context, what appears dangerous is not the V(T)/kg ratio but instead the V(T)/baby lung ratio. The practical message is straightforward: the smaller the baby lung, the greater is the potential for unsafe mechanical ventilation.
Acute respiratory distress syndrome; Baby lung; Baro-/volutrauma; Mechanical ventilation; Respiratory system compliance; Ventilator-induced lung injury
Settore MED/41 - Anestesiologia
giu-2005
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/15836
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