Alveolar tissue and pulmonary capillary injury is caused by which of the following?

a. Barotrauma
b. Biotrauma
c. Shear stress
d. Overdistention


ANS: C
Repeated opening and closing of lung units, also called recruitment/derecruitment, generates shear stress, which results in direct tissue injury at the alveolar and pulmonary capillary level. Barotrauma is lung injury caused by high pressure. Biotrauma refers to the release of inflamma-tory chemical mediators that cause multiorgan failure. Overdistention is the cause of biotrauma.

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