American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Aug 2014
Ventilator-induced Lung Injury: Similarity and Differences Between Children and Adults.
It is well established that mechanical ventilation can injure the lung, producing an entity known as ventilator-induced lung injury (VILI). There are various forms of VILI, including volutrauma (i.e., injury caused by overdistending the lung), atelectrauma (injury due to repeated opening/closing of lung units), and biotrauma (release of mediators that can induce lung injury or aggravate pre-existing injury, potentially leading to multiple organ failure). ⋯ Given the physiological and biological differences in the respiratory systems of infants, children, and adults, it is difficult to directly extrapolate clinical practice from adults to children. This Critical Care Perspective analyzes the relevance of VILI to the pediatric population, and addresses why pediatric patients might be less susceptible than adults to VILI.
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Am. J. Respir. Crit. Care Med. · Aug 2014
Impaired Angiogenesis and Peripheral Muscle Microcirculation Loss Contributes to Exercise Intolerance in Pulmonary Arterial Hypertension.
Pulmonary arterial hypertension (PAH) is characterized by significant exercise intolerance, which is multifactorial and involves skeletal muscle alterations. There is growing evidence that microRNAs (miRs) are involved in PAH pathogenesis. ⋯ We demonstrate for the first time that exercise intolerance in PAH is associated with skeletal muscle microcirculation loss and impaired angiogenesis secondary to miR-126 down-regulation.