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Critical Reviews™ in Biomedical Engineering
SJR: 0.207 SNIP: 0.376 CiteScore™: 0.79

ISSN Печать: 0278-940X
ISSN Онлайн: 1943-619X

Выпуски:
Том 47, 2019 Том 46, 2018 Том 45, 2017 Том 44, 2016 Том 43, 2015 Том 42, 2014 Том 41, 2013 Том 40, 2012 Том 39, 2011 Том 38, 2010 Том 37, 2009 Том 36, 2008 Том 35, 2007 Том 34, 2006 Том 33, 2005 Том 32, 2004 Том 31, 2003 Том 30, 2002 Том 29, 2001 Том 28, 2000 Том 27, 1999 Том 26, 1998 Том 25, 1997 Том 24, 1996 Том 23, 1995

Critical Reviews™ in Biomedical Engineering

DOI: 10.1615/CritRevBiomedEng.v39.i4.40
pages 297-318

Role of Airway Recruitment and Derecruitment in Lung Injury

Samir Ghadiali
The Ohio State University
Y. Huang
Department of Biomedical Engineering, Ohio State University, Columbus, Ohio; Davis Heart & Lung Research Institute, Ohio State University, Columbus, Ohio

Краткое описание

The mechanical forces generated during the ventilation of patients with acute lung injury causes significant lung damage and inflammation. Low-volume ventilation protocols are commonly used to prevent stretch-related injury that occurs at high lung volumes. However, the cyclic closure and reopening of pulmonary airways at low lung volumes, i.e., derecruitment and recruitment, also causes significant lung damage and inflammation. In this review, we provide an overview of how biomedical engineering techniques are being used to elucidate the complex physiological and biomechanical mechanisms responsible for cellular injury during recruitment/derecruitment. We focus on the development of multiscale, multiphysics computational models of cell deformation and injury during airway reopening. These models, and the corresponding in vitro experiments, have been used to both elucidate the basic mechanisms responsible for recruitment/derecruitment injury and to develop alternative therapies that make the epithelium more resistant to injury. For example, models and experiments indicate that fluidization of the cytoskeleton is cytoprotective and that changes in cytoskeletal structure and cell mechanics can be used to mitigate the mechanotransduction of oscillatory pressure into inflammatory signaling. The continued application of biomedical engineering techniques to the problem of recruitment/derecruitment injury may therefore lead to novel and more effective therapies.


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