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01-05-2016 | Review

The "baby lung" became an adult

Authors: Luciano Gattinoni, John J. Marini, Antonio Pesenti, Michael Quintel, Jordi Mancebo, Laurent Brochard

Published in: Intensive Care Medicine | Issue 5/2016

Abstract

The baby lung was originally defined as the fraction of lung parenchyma that, in acute respiratory distress syndrome (ARDS), still maintains normal inflation. Its size obviously depends on ARDS severity and relates to the compliance of the respiratory system. CO₂ clearance and blood oxygenation primarily occur within the baby lung. While the specific compliance suggests the intrinsic mechanical characteristics to be nearly normal, evidence from positron emission tomography suggests that at least a part of the well-aerated baby lung is inflamed. The baby lung is more a functional concept than an anatomical one; in fact, in the prone position, the baby lung “shifts” from the ventral lung regions toward the dorsal lung regions while usually increasing its size. This change is associated with better gas exchange, more homogeneously distributed trans-pulmonary forces, and a survival advantage. Positive end expiratory pressure also increases the baby lung size, both allowing better inflation of already open units and adding new pulmonary units. Viewed as surrogates of stress and strain, tidal volume and plateau pressures are better tailored to baby lung size than to ideal body weight. Although less information is available for the baby lung during spontaneous breathing efforts, the general principles regulating the safety of ventilation are also applicable under these conditions.

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Title: The "baby lung" became an adult
Authors: Luciano Gattinoni
John J. Marini
Antonio Pesenti
Michael Quintel
Jordi Mancebo
Laurent Brochard
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 5/2016
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-015-4200-8

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Springer Medicine

The "baby lung" became an adult

Abstract

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Springer Medicine

Abstract

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