Lung-protective ventilation and adjunctive strategies to manage respiratory failure: are they safe in the neurological patient?
| Autor: | Robert Stevens, Pirouz Piran |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
ARDS
medicine.medical_specialty medicine.medical_treatment Population Critical Care and Intensive Care Medicine 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine Intensive care Extracorporeal membrane oxygenation Humans Medicine education Intensive care medicine Lung Intracranial pressure Mechanical ventilation Respiratory Distress Syndrome education.field_of_study business.industry 030208 emergency & critical care medicine medicine.disease Respiration Artificial 030228 respiratory system Respiratory failure Breathing Respiratory Insufficiency business |
| Zdroj: | Current Opinion in Critical Care. 27:115-119 |
| ISSN: | 1531-7072 1070-5295 |
| DOI: | 10.1097/mcc.0000000000000809 |
| Popis: | Purpose of review The coexistence of neurological injury and respiratory failure is common in intensive care. This article provides a contemporary overview of the safety and efficacy of different strategies for mechanical ventilation and adjunctive respiratory approaches in patients with acute brain injury. Recent findings Available evidence indicates that lung-protective ventilation (LPV) can be implemented safely in a range of patients with concurrent respiratory failure and brain injury of different etiologies; however, the clinical efficacy of LPV in this setting needs to be established. In patients who have severe acute respiratory distress syndrome (ARDS) and brain injury, adjunctive measures (neuromuscular blocker drug infusions, prone positioning, extracorporeal membrane oxygenation) may be considered, although the neurophysiological impact and safety of these techniques need further investigation. Intracranial pressure and other neuromonitoring techniques may be of value to ensure optimal management of mechanical ventilation and adjunctive measures in this population. Summary Research is needed to determine the safety, feasibility, and efficacy of LPV and adjunctive approaches for managing patients with concurrent brain injury and respiratory failure. |
| Databáze: | OpenAIRE |
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