The original in vivo study of ventilator-induced lung injury by Webb and Tierney (1974) reported that high VT with zero PEEP caused overwhelming lung injury, subsequently shown by others to be due to lung shear stress.
To reproduce the lung injury and edema in the 'Webb and Tierney' study and investigate the mechanism.
Sprague-Dawley rats (≈400 g) received mechanical ventilation for 60 min according to the protocol of Webb and Tierney (14/0, 30/0, 45/10, 45/0 cmH2O). Additional series of experiments (20 min duration, to ensure all animals survived) were studied to assess permeability (4/group), echocardiography (4/group), and right and left ventricular pressure (5 and 4/group, respectively).
The original Webb & Tierney results were replicated in terms of lung/body weight ratio (45/0 > 45/10 ≈ 30/0 ≈ 14/0; P<0.05), and histology. In 45/0, pulmonary edema was overt and rapid, with survival less than 30 min. In 45/0 (but not 45/10), there was an increase in microvascular permeability, cyclical abolition of preload, and progressive dilation of the right ventricle. While left ventricular end-diastolic pressure decreased in 45/10, it increased in 45/0.
In a classic model of VILI high peak pressure (and zero PEEP) causes respiratory swings (obliteration during inspiration) in RV filling and pulmonary perfusion, and ultimate RV failure and dilation. Pulmonary edema was due to increased permeability, augmented by a modest (approximately 40%) increase in hydrostatic pressure. The mechanism of cor pulmonale is uncertain but might be due to pulmonary microvascular injury from cyclic interruption/exaggeration of flow.
This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 September 2025.
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#53
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Altmetric has tracked 34,411,289 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 15,143 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.0. This one has done well, scoring higher than 79% of its peers.
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