Effect of mechanical ventilation on the kidney

Mechanical ventilation is a standard component of intensive care unit management of critically ill patients and is widely used for respiratory support. Recent animal and clinical studies have shown that positive pressure ventilation can worsen pre-existing lung injury and produce ventilator-induced lung injury, which has been linked with the development of systemic inflammation and multi-system organ dysfunction, including renal failure. Although the physiological consequences of mechanical ventilation on pulmonary and cardiovascular function have been extensively studied, its effects on renal function are not as well defined. Previous experimental studies and few clinical reports have shown a significant effect of mechanical ventilation on renal function. Interestingly, recent data are emerging which suggest that renal dysfunction also has a direct, adverse effect on pulmonary function. This chapter reviews the information in these areas and provides a framework for future investigation in this field.