Respiratory Rate as a Factor in Lung Injury—Not Just What You Set, but How You Set

Editorial| April 2023 Respiratory Rate as a Factor in Lung Injury—Not Just What You Set, but How You Set Kanji Uchida, M.D., Ph.D. Kanji Uchida, M.D., Ph.D. 1Department of Anesthesiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information This editorial accompanies the article on p. 420. Accepted for publication January 10, 2023. Address correspondence to Dr. Uchida: Anesthesiology April 2023, Vol. 138, 351–353. https://doi.org/10.1097/ALN.0000000000004502 Connected Content Article: Lung Injury Is Induced by Abrupt Increase in Respiratory Rate but Prevented by Recruitment Maneuver in Mild Acute Respiratory Distress Syndrome in Rats Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation Kanji Uchida; Respiratory Rate as a Factor in Lung Injury—Not Just What You Set, but How You Set. Anesthesiology 2023; 138:351–353 doi: https://doi.org/10.1097/ALN.0000000000004502 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: lung injuries, respiratory rate Respiratory support with mechanical ventilation is crucial for critically ill patients with diseases such as acute respiratory distress syndrome (ARDS), in which the pulmonary gas exchange capacity is impaired. However, ventilation itself exposes the lungs to a nonphysiologic environment, which in itself injures the lungs. Reports on ventilator settings that have been shown to affect patient outcomes have focused on low tidal volume (VT)1 and adequate driving pressure.2 Additionally, the concepts of pressure (barotrauma), VT (volutrauma), and cyclic opening–closing of the lung units (atelectrauma) have been proposed as mechanisms of ventilation-induced lung injury. Ventilator settings that minimize each of these factors were subsequently studied and discussed. Although the respiratory rate is an essential item in the ventilator setting, it has received little attention because it is passively adjusted after the VT setting. Animal studies have shown that increasing the respiratory rate exacerbates ventilation-induced lung... You do not currently have access to this content.