ArticlePloS one2018
Alveolar leak develops by a rich-get-richer process in ventilator-induced lung injury.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
31 citing papers in PubMed, 42 citations in OpenAlex.
- Heart-Lung Interactions in Gas Exchange: From Physiology to Pathophysiology.Comprehensive Physiology · 2026Review
- Maternal Diet Quality and Third Trimester Depression: Insights From a Nepali Birth Cohort Study.Maternal & child nutrition · 2026Article
- Role of Tidal Volume on Ventilator-Induced Lung Injury Under Heterogeneous Immunological Capabilities: A Mathematical Model Study.Life (Basel, Switzerland) · 2025Article
- Dynamic driving pressure predicts ventilator-induced lung injury in mice with and without endotoxin-induced acute lung injury.American journal of physiology. Lung cellular and molecular physiology · 2025Article
- Exploring alveolar recruitability using positive end-expiratory pressure in mice overexpressing TGF-β1: a structure-function analysis.Scientific reports · 2024Article
- Modelling lung diffusion-perfusion limitation in mechanically ventilated SARS-CoV-2 patients.Frontiers in physiology · 2024Article
- A scale-free model of acute and ventilator-induced lung injury: a network theory approach inspired by seismology.Frontiers in network physiology · 2024Article
- Early Endothelial Signaling Transduction in Developing Lung Edema.Life (Basel, Switzerland) · 2023Review
- Ventilator-Induced Lung Injury as a Dynamic Balance Between Epithelial Cell Damage and Recovery.Annals of biomedical engineering · 2023Article
- Acute Lung Injury in aortic dissection : new insights in anesthetic management strategies.Journal of cardiothoracic surgery · 2023Review
- The impact of heterogeneity of the air-blood barrier on control of lung extravascular water and alveolar gas exchange.Frontiers in network physiology · 2023Review
- Assessment of Heterogeneity in Lung Structure and Function During Mechanical Ventilation: A Review of Methodologies.Journal of engineering and science in medical diagnostics and therapy · 2022Review
- Protective ventilation in a pig model of acute lung injury: timing is as important as pressure.Journal of applied physiology (Bethesda, Md. : 1985) · 2022Article
- Spatiotemporal distribution of cellular injury and leukocytes during the progression of ventilator-induced lung injury.American journal of physiology. Lung cellular and molecular physiology · 2022Article
- Pulmonary Interstitial Matrix and Lung Fluid Balance From Normal to the Acutely Injured Lung.Frontiers in physiology · 2021Review
- The POOR Get POORer: A Hypothesis for the Pathogenesis of Ventilator-induced Lung Injury.American journal of respiratory and critical care medicine · 2020Review
- Effect of low-dose exogenous surfactant on infants with acute respiratory distress syndrome after cardiac surgery: a retrospective analysis.BMC pulmonary medicine · 2020Observational
- Prevention and treatment of acute lung injury with time-controlled adaptive ventilation: physiologically informed modification of airway pressure release ventilation.Annals of intensive care · 2020Review
- A Physiologically Informed Strategy to Effectively Open, Stabilize, and Protect the Acutely Injured Lung.Frontiers in physiology · 2020Review
- Three Alveolar Phenotypes Govern Lung Function in Murine Ventilator-Induced Lung Injury.Frontiers in physiology · 2020Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
Acute respiratory distress syndrome (ARDS) is a life-threatening condition for which there are currently no medical therapies other than supportive care involving the application of mechanical ventilation. However, mechanical ventilation itself can worsen ARDS by damaging the alveolocapillary barrier in the lungs. This allows plasma-derived fluid and proteins to leak into the airspaces of the lung where they interfere with the functioning of pulmonary surfactant, which increases the stresses of mechanical ventilation and worsens lung injury. Once such ventilator-induced lung injury (VILI) is underway, managing ARDS and saving the patient becomes increasingly problematic. Maintaining an intact alveolar barrier thus represents a crucial management goal, but the biophysical processes that perforate this barrier remain incompletely understood. To study the dynamics of barrier perforation, we subjected initially normal mice to an injurious ventilation regimen that imposed both volutrauma (overdistension injury) and atelectrauma (injury from repetitive reopening of closed airspaces) on the lung, and observed the rate at which macromolecules of various sizes leaked into the airspaces as a function of the degree of overall injury. Computational modeling applied to our findings suggests that perforations in the alveolocapillary barrier appear and progress according to a rich-get-richer mechanism in which the likelihood of a perforation getting larger increases with the size of the perforation. We suggest that atelectrauma causes the perforations after which volutrauma expands them. This mechanism explains why atelectrauma appears to be essential to the initiation of VILI in a normal lung, and why atelectrauma and volutrauma then act synergistically once VILI is underway.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.