The Inflammatory Cascade Babies are incredibly fragile Even normal, careful, appropriate ventilation can trigger the inflammatory response Moral: we can’t blame ourselves when a baby dies or suffers chronic lung injury

Normal Alveolus Alveolar Air Space Type I Cell Surfactan t Layer Type II Cell Interstitium Capillary Red Cell Alveolar Macrophag e Basement Membrane

Normal AlveolusInjured Alveolus (acute phase) Sloughing Bronchial Epithelium Edema Necrotizing or Apoptotic Type I Cells Inactivated Surfactant Red Cells Activated Neutrophil Cellular Debris Fibrin Hyaline Membrane Disease Interstitial Pneumonia Denuded Basement Membrane Alveolar Air Space Type I Cell Surfactan t Layer Type II Cell Interstitium Capillary Red Cell Alveolar Macrophag e Basement Membrane