Opening Up to Lung Recruitment Pulmonary Contusion and Derecruitment - The Role of Inflammation

Purpose of review: It was recently reported that a lung protective ventilation strategy resulted in no fatalities in 17 patients with ARDS secondary to lung contusion. Although the efficacy of a lung protective ventilation strategy to reduce mortality in ARDS pa- tients has been demonstrated, the underlying mecha- nisms for this reduction remain unclear. Recent findings: ARDS is characterized by an inflammatory state of the lung that can be aggravated by mechanical ventilation. Especially mechanical ven- tilation allowing cyclic opening and closing of unstable alveoli, enhances cytokine release and can even result in loss of compartmentalization. Disbalance in the cytokine response can promote bacterial colonization