Patient-Self Inflicted Lung Injury (P-SILI): An Insight into the Pathophysiology of Lung Injury and Management

Authors

Himanshu Deshwal, Division of Pulmonary, Sleep and Critical Care Medicine, Department of Medicine, School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
Ahmed Elkhapery, Rochester Regional HealthFollow
Rudra Ramanathan, Division of Pulmonary, Sleep and Critical Care Medicine, School of Medicine, New York University Grossman, New York, NY 10016, USA.
Deepak Nair, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.
Isha Singh, Department of Medicine, School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
Ankur Sinha, Section of Interventional Pulmonology, Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, Stanford University, Stanford, CA 94305, USA.
Rishik Vashisht, Division of Pulmonary and Critical Care Medicine, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA 23508, USA.
Vikramjit Mukherjee, Division of Pulmonary, Sleep and Critical Care Medicine, School of Medicine/Bellevue Hospital, New York University Grossman, New York, NY 10016, USA.

Department

Medicine

Document Type

Article

Publication Title

Journal of Clinical Medicine

Abstract

Acute respiratory distress syndrome (ARDS) is a heterogeneous group of disease entities that are associated with acute hypoxic respiratory failure and significant morbidity and mortality. With a better understanding and phenotyping of lung injury, novel pathophysiologic mechanisms demonstrate the impact of a patient's excessive spontaneous breathing effort on perpetuating lung injury. Patient self-inflicted lung injury (P-SILI) is a recently identified phenomenon that delves into the impact of spontaneous breathing on respiratory mechanics in patients with lung injury. While the studies are hypothesis-generating and have been demonstrated in animal and human studies, further clinical trials are needed to identify its impact on ARDS management. The purpose of this review article is to highlight the physiologic mechanisms of P-SILI, novel tools and methods to detect P-SILI, and to review the current literature on non-invasive and invasive respiratory management in patients with ARDS.

DOI

10.3390/jcm14051632

Volume

14

Issue

5

Publication Date

2-27-2025

PubMed ID

40095610

Recommended Citation

Deshwal, H., Elkhapery, A., Ramanathan, R., Nair, D., Singh, I., Sinha, A., Vashisht, R., & Mukherjee, V. (2025). Patient-Self Inflicted Lung Injury (P-SILI): An Insight into the Pathophysiology of Lung Injury and Management. Journal of Clinical Medicine, 14 (5) https://doi.org/10.3390/jcm14051632