Mechanical Ventilation: A Double-Edged Sword

Mechanical ventilation initiates a vicious circle

The vicious circle: every form of mechanical ventilation is unphysiological and causes further damage to the lung.

Cascades of lung failure (VALI, VILI) and multi-organ failure are initiated, in which inflammatory mediators are released from lung tissue (biotrauma) and biophysical stresses such as volutrauma, barotrauma and atelectrauma lead to damage in other organs such as the liver or kidney. The most common cause of death in patients with lung failure is thus the subsequent multi-organ failure.[1]

 

 

 

Since the atrophy of the respiratory muscules begins quickly during mechanical ventilation (VIDD), the highest priority must be given to maintaining spontaneous breathing.[2] Intubated patients are exposed to the additional risk of acquiring ventilator-associated pneumonia (VAP), which leads to a further increase in mortality.

 

Atrophy of muscle cells after ≤ 3 hours (B) or > 18 hours (A) of mechanical ventilation; Source: Levine et al., N Eng J Med 2008

 

 

 

Novalung products break the vicious circle

To break the vicious circle, Novalung products help the lung heal. The use of the iLA Membrane Ventilator® artificial lung enables new therapeutic concepts in lung protection with the goal of eliminating invasive mechanical ventilation altogether. Even if invasive ventilation is still required it is possible to achieve a level of lung protection that far exceeds previous standards (so-called “ultraprotective ventilation“).

High-frequency oscillatory ventilation with the Vision α® plays an important role here, since key principles of lung-protective ventilation can be achieved using HFO ventilation.

 

On the following pages you will find extensive information on the various therapeutic options that are made possible by Novalung’s innovative products. Contact us if you are interested in more detailed information.

[1] Slutsky et al., Am J Resp Crit Care Med 1998.
[2] Levine et al., N Engl J Med 2008; Vol. 358:13271335.