Redox imbalance and ventilator-induced lung injury

Mechanical ventilation (MV) is an indispensable therapy in the care of critically ill patients with acute lung injury and the acute respiratory distress syndrome; however, it is also known to further lung injury in certain conditions of mechanical stress, leading to ventilator-induced lung injury (VILI). The mechanisms by which conventional MV exacerbates lung injury and inflammation are of considerable clinical significance. Redox imbalance has been postulated, among other mechanisms, to enhance/perpetuate susceptibility to VILI. A better understanding of these pathologic mechanisms will help not only in alleviating the side effects of mechanical forces but also in the development of new therapeutic strategies. Here, we review the relevance of oxidative stress in VILI from human studies as well as cellular and mouse models of mechanical stress. Potential therapeutic avenues for the treatment of VILI with exogenous administration of antioxidants also are discussed.