medicine Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...

, atelectotrauma, atelectrauma, cyclic atelectasis or repeated alveolar collapse and expansion (RACE) is the damage caused to the lung by

mechanical ventilation Mechanical ventilation or assisted ventilation is the Medicine, medical term for using a ventilator, ventilator machine to fully or partially provide artificial ventilation. Mechanical ventilation helps move air into and out of the lungs, wit ...

under certain conditions.

Disorder

When parts of the lung collapse at the end of expiration, due to a combination of a diseased lung state and a low

functional residual capacity Functional residual capacity (FRC) is the lung volume, volume of air present in the lungs at the end of passive Exhalation, expiration.Hopkins E, Sharma S. Physiology, Functional Residual Capacity. pdated 2022 Jan 4 In: StatPearls nternet...

, then reopen again on inspiration, this repeated collapsing and reopening causes

shear stress Shear stress (often denoted by , Greek alphabet, Greek: tau) is the component of stress (physics), stress coplanar with a material cross section. It arises from the shear force, the component of force vector parallel to the material cross secti ...

which has a damaging effect on the

alveolus Alveolus (; pl. alveoli, adj. alveolar) is a general anatomical term for a concave cavity or pit. Uses in anatomy and zoology * Pulmonary alveolus, an air sac in the lungs ** Alveolar cell or pneumocyte ** Alveolar duct ** Alveolar macrophage * M ...

.Shi C., Boehme S., Hartmann E. K., Markstaller K. Novel technologies to detect atelectotrauma in the injured lung. ''Exp Lung Res''. 2011 Feb;37(1):18-25.

/ref>Attar MA, Donn SM. Mechanisms of ventilator-induced lung injury in premature infants. ''Semin Neonatol''. 2002 Oct;7(5):353-60.

/ref> Clinicians attempt to reduce atelectotrauma by ensuring adequate

positive end-expiratory pressure Positive end-expiratory pressure (PEEP) is the pressure in the lungs ( alveolar pressure) above atmospheric pressure (the pressure outside of the body) that exists at the end of expiration. The two types of PEEP are extrinsic PEEP (PEEP applied by ...

(PEEP) to maintain the alveoli open in expiration. This is known as ''open lung ventilation''. High-frequency oscillatory ventilation (HFOV) with its use of super

continuous positive airway pressure Continuous positive airway pressure (CPAP) is a form of positive airway pressure (PAP) ventilation in which a constant level of pressure greater than atmospheric pressure is continuously applied to the upper respiratory tract of a person. The a ...

(CPAP) is especially effective in preventing atelectotrauma since it maintains a very high

mean airway pressure Mean airway pressure typically refers to the mean pressure applied during positive-pressure mechanical ventilation. Mean airway pressure correlates with alveolar ventilation, arterial oxygenation, hemodynamic performance, and barotrauma. It can ...

(MAP), equivalent to a very high PEEP. Atelectotrauma is one of several means by which mechanical ventilation may damage the lungs leading to

ventilator-associated lung injury Ventilator-associated lung injury (VALI) is an acute lung injury that develops during mechanical ventilation and is termed ventilator-induced lung injury (VILI) if it can be proven that the mechanical ventilation caused the acute lung injury. In ...

. The other means are

volutrauma Barotrauma is physical damage to body fluid compartments, tissues caused by a difference in pressure between a gas space inside, or in contact with, the body and the surrounding gas or liquid. The initial damage is usually due to over-stretchin ...

barotrauma Barotrauma is physical damage to body tissues caused by a difference in pressure between a gas space inside, or in contact with, the body and the surrounding gas or liquid. The initial damage is usually due to over-stretching the tissues in ...

, rheotrauma and

biotrauma Although the term has occasionally been used in other ways, in medical literature biotrauma is usually defined as a severe inflammatory response produced in the lungs of patients who breathe by means of a Mechanical ventilation, mechanical ventilat ...

. Attempts have been made to combine these factors in an all encompassing term:

mechanical power Power is the amount of energy transferred or converted per unit time. In the International System of Units, the unit of power is the watt, equal to one joule per second. Power is a scalar quantity. Specifying power in particular systems may re ...

References

{{Mechanical ventilation Respiratory therapy Pulmonology Lung disorders Emergency medicine Intensive care medicine Trauma types Medical equipment