Certain serious illnesses, including pneumonia and the acute respiratory distress syndrome (ARDS), can lead to fluid accumulation in the lung and obstruction of the small pulmonary airways. Fluid in the lungs inhibits gas exchange and patients may require mechanical ventilation, which can expose the lung to mechanical stresses that exacerbate the existing injury and result in additional fluid accumulation. Recent improvements in ventilation protocols (e.g. low lung volume ventilation) have improved ARDS treatment, but mortality rates remain high (30–40%).

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