Parenchymal lung injury

Because alveolar recruitment is less of an issue in obstructive lung injury than in parenchymal lung injury, the need for PEEP is less. Table 2 summarizes an approach to ventilation for patients with obstructive airway disease. A role for PEEP occurs when intrinsic PEEP serves as an inspiratory threshold load for the patient attempting to trigger a breath. Under these conditions, judicious application of PEEP, up to 75-85% of measured intrinsic PEEP, can balance expiratory pressure throughout the ventilator circuitry to facilitate the triggering process (71,72). 

Barth, P. I, Muller, B., Wagner, U. and Bittinger, A. (1995) Quantitative analysis of parenchymal and vascular alterations in N02 induced lung injury in rats. European Respiratory Journal 8,1115-21. 

Farer LS (1976) Isoniazid and liver injury. Ann Intern Med 84 753 Feinmann L (1975) Lung parenchymal changes due to ingested substances. Drug-induced lung disease pulmonary eosinophilia and sulphonamides. Proc R Soc Med 68 440 Fellner MJ (1970) Nebenwirkungen durch Isonicotinsaurehydrazid. Hautarzt 21 320 Flach A (1981) Photosensitivity to sulfisoxazole ointment. Arch Ophthalmol 99 609 Fleck R (1981) Nitrofurantoin toxicity. Pa Med 84 36... 

SLE is a common CTD with frequent chest manifestations (Table 3). The most common chest manifestation is pleurisy that can occur with or without a pleural effusion. Although ILD has been described in SLE, more common is a presentation of lung parenchymal injury called lupus pneumonitis. SLE may also cause alveolar hemorrhage, a particularly serious form of lung involvement. This review will discuss what is known about these disease states. 

---