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Ventilator-Associated Lung Injury Decreases Lung Ability To Clear Edema and Downregulates Alveolar Epithelial Cell Na,K-Adenosine Triphosphatase Function*

E. Lecuona, PhD; F. Saldías, MD; A. Comellas, MD; K. Ridge, PhD; C. Guerrero, PhD; J. I. Sznajder, MD, FCCP
Author and Funding Information

*From the Division of Pulmonary and Critical Care Medicine, Michael Reese Hospital, University of Illinois at Chicago, Chicago, IL, and Departamento de Enfermedades Respiratorias, Facultad de Medicina de la Pontificia Universidad Católica de Chile, Santiago, Chile.

Correspondence to: Jacob I. Sznajder, MD, Department of Medicine, Tarry Bldg 14-707, 303 E Superior St, Chicago, IL 60611



Chest. 1999;116(suppl_1):29S-30S. doi:10.1378/chest.116.suppl_1.29S
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Extract

Mechanical ventilation is used in the treatment of patients with respiratory failure, but ventilation with high tidal volumes (HVts) can cause volutrauma. In animal models, HVt ventilation may cause lung injury and pulmonary edema by overdistending the lung (volutrauma).12 The clearance of pulmonary fluid is effected mostly by active Na+ transport out of the alveoli, predominantly by the apical Na+ channels and the basolaterally located Na,K-adenosine triphosphatases (ATPases), which generate the electrochemical gradient responsible for the vectorial Na+ flux from the airspaces and water following isosmotically.5


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