Acute Lung Injury and Bacterial Infection
Section snippets
Bacterial superinfection in animals with acute lung injury
Bacterial superinfection in ALI has been the subject of important experimental investigation since the pioneer investigations conducted by Johanson's team. The effects of hyperoxia-induced lung injury on bacterial dissemination were evaluated during lung infection in hamsters [10]. Exposure to 100% oxygen for several days enhanced lung bacterial growth in animals that received an intratracheal instillation of Pseudomonas aeruginosa. Air-breathing animals developed focal bronchopneumonia, but
Altered immunity during acute lung injury and mechanical ventilation
Many experimental and clinical studies have evaluated whether ALI is responsible for a change in lung and systemic defense against infection. In particular, alveolar macrophage and neutrophil functions have been studied, as well as the influence of lung injury on the inflammatory cytokine network. It is beyond the scope of this article to review the abundant literature in this field in detail, especially in the light of multiple uncertainties.
Clinical studies of ventilator-associated pneumonia during acute respiratory distress syndrome
The impact of VAP on mortality and morbidity is debated [40], [41] and is discussed in detail elsewhere in this issue. VAP may affect the outcome in patients with ARDS by worsening hypoxemia and causing sepsis and related multiple system organ failure. Initial clinical and histologic studies have revealed that VAP may be observed in 20% to 75% of patients dying with ARDS [7], [8], [39], [42]. Nevertheless, several methodologic problems must be overcome when one tries to assess the exact
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