![]() ![]() The restricted capacity of this ‘baby lung’ is primarily responsible for the mechanical characteristics described in ARDS. Possible harm from mechanical ventilation is understandable if the ARDS lung is modeled in two regions, one nearly normal and having dimensions similar to those of a healthy baby (Fig. Whatever the cause of ARDS, the treatment of symptoms is mandatory to buy time for the resolution of the underlying process, such as pneumonia or sepsis. The symptoms involved are impaired gas exchange, decreased lung compliance, increased lung weight and widespread involvement of the lung parenchyma. Several diseases may produce the syndrome called acute respiratory distress syndrome (ARDS). 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. Viewed as surrogates of stress and strain, tidal volume and plateau pressures are better tailored to baby lung size than to ideal body weight. Positive end expiratory pressure also increases the baby lung size, both allowing better inflation of already open units and adding new pulmonary units. This change is associated with better gas exchange, more homogeneously distributed trans-pulmonary forces, and a survival advantage. 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. ![]() 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. CO 2 clearance and blood oxygenation primarily occur within the baby lung. Its size obviously depends on ARDS severity and relates to the compliance of the respiratory system. The baby lung was originally defined as the fraction of lung parenchyma that, in acute respiratory distress syndrome (ARDS), still maintains normal inflation. ![]()
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