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. 2018 May 24;22:136. doi: 10.1186/s13054-018-2051-8

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© The Author(s). 2018

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Fig. 5 — Interdependent “alveoli” with shared walls represented by hexagons at inspiration and expiration. In the center of the “alveolar tissue” there are a group of heterogeneously (H) collapsed alveoli causing a stress-riser. Since alveoli share walls, the open alveoli connected to collapsed alveoli are subject to a concentration of the force applied to lung tissue by the tidal volume. Note that the over-distension and distortion are most significant in alveoli surrounding H during expiration (asterisks). Stress-risers are a key mechanism of ventilator-induced lung injury [8]