TNF and injury: Dhanireddy S found that mechanical ventilation could exacerbate both pulmonary and systemic inflammation in response to bacteria and contribute to the pathogenesis of both acute lung injury and multiple organ dysfunction syndromes, it could augment pulmonary production of the proinflammatory cytokines KC, MIP-2, TNF-alpha, and IL-6 and increase the alveolar-capillary permeability to proteins [27].