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Editorial
. 2020 Aug;8(16):985.
doi: 10.21037/atm-20-2050.

Protecting the lungs but hurting the kidneys: causal inference study for the risk of ventilation-induced kidney injury in ARDS

Haopu Yang  1   2   3 , Panayiotis V Benos  2 , Georgios D Kitsios  3   4
Affiliations
Editorial

Protecting the lungs but hurting the kidneys: causal inference study for the risk of ventilation-induced kidney injury in ARDS

Haopu Yang et al. Ann Transl Med. 2020 Aug.
No abstract available

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-2050). HY reports other from China Scholarship Council, outside the submitted work; GDK reports grants from Karius Inc., outside the submitted work. The other author has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Mechanisms of plausible mechanisms of ventilator-induced kidney injury. (A) Gas exchange disturbances, which typically include hypoxemia and hypercapnia, lower renal vascular resistance and lead to a drop in glomerular filtration rate (GFR); (B) hemodynamics changes during invasive mechanical ventilation (IMV) can cause an increase in intrathoracic and right atrial pressures and thus a decrease in cardiac output and venous return, consequently lowering GFR; (C) inflammatory mediators from the lungs trigger both endothelial and epithelial injury in glomeruli and renal tubules (not shown). TNF, tumor necrosis factor.
Figure 2
Figure 2
Positive end-expiratory pressure (PEEP) during mechanical ventilation is causally-linked to acute kidney injury (AKI). The study by Leite et al. showed that constantly applied PEEP was causally-linked to AKI while the cyclic rises in pulmonary pressures from tidal volume delivery with each mechanical breath was not.
See this image and copyright information in PMC

Comment on

References

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