How can barotrauma occur during mechanical ventilation?

Barotrauma occurs when there is an injury to the lung tissue caused by excessive pressure. In the context of mechanical ventilation, this situation can arise when excessive airway pressures are used, leading to overdistension of the alveoli. When the pressure within the alveoli exceeds the threshold that the lung tissue can tolerate, it can cause the alveoli to rupture and potentially result in a pneumothorax or other serious lung injuries. This risk highlights the importance of controlling ventilatory pressures and ensuring that they remain within safe limits to prevent barotrauma during mechanical ventilation.

Factors such as low tidal volumes and inadequate positive end-expiratory pressure (PEEP) do not directly contribute to barotrauma, with low tidal volumes potentially resulting in insufficient lung inflation rather than overdistension. Similarly, improper patient positioning, while it may affect overall lung mechanics and gas exchange, does not inherently lead to the excessive pressures necessary for barotrauma to occur.