Risk also appears to be increased by aspiration of stomach contents and pre-existing disease such as necrotising pneumonia and chronic lung disease. Status asthmaticus is a particular problem as it requires relatively high pressures to overcome bronchial obstruction.When lung tissues are damaged by alveolar over-distension, the injury may be termed volutrauma, but volume and transpulmonary pressure are closely related. Ventilator induced lung injury is often associated with high tidal volumes (Vt). Pathophysiology
Lung overpressure injury
A free-diver can dive and safely ascend without exhaling, because the gas in the lungs had been inhaled at atmospheric pressure, is compressed during the descent, and expands back to the original volume during ascent. A scuba or surface-supplied diver breathing gas at depth from underwater breathing apparatus fills their lungs with gas at a ambient pressure greater than atmospheric pressure. At 10 metres the lungs contain twice the amount of gas that they would contain at atmospheric pressure, and if they ascend without exhaling the gas will expand to match the decreasing pressure until the lungs reach their elastic limit, and begin to tear, and is very likely to sustain life-threatening lung damage. Besides tissue rupture, the overpressure may cause ingress of gases into the tissues through the ruptures, and further afield through the circulatory system. Pulmonary barotrauma (PBt) of ascent is also known as pulmonary over-inflation syndrome (POIS), lung over-pressure injury (LOP) and burst lung.
Promising techniques to reduce the rate of failure include an orthopedic anchoring system, a gluteus maximus muscle flap, an acellular human dermis graft, and an acellular pig collagen graft. In dogs and cats

In dogs, perineal hernia usually is found on the right side. Most cases are in older intact (not neutered) male dogs (93 percent in one study). Breeds that may be at risk include Welsh Corgis, Boxers, Australian Kelpies, Boston Terriers, Collies, Dachshunds, Old English Sheepdogs, and Pekingese. Perineal hernias are rare in female dogs and uncommon in cats. Dogs with benign prostatic hyperplasia have been found to have increased relaxin levels and suspected subsequent weakening of the pelvic diaphragm. In cats, perineal hernias are seen most commonly following perineal urethrostomy surgery or secondary to megacolon. Medical treatment consists of treatment of the underlying disease, enemas, and stool softeners. Because only about 20 percent of cases treated medically are free of symptoms, surgery is often necessary. Recurrence is common with or without surgery. Several surgeries have been described for perineal hernias in dogs. The current standard involves transposition of the internal obturator muscle. This technique has a lower recurrence and complication rate than traditional hernia repair. A new technique uses porcine small intestinal submucosa as a biomaterial to help repair the defect. This is can also be done in combination with internal obturator muscle transposition, especially when that muscle is weak. == References ==