J Neurocrit Care.  2017 Jun;10(1):1-6. 10.18700/jnc.170009.

Brain and Lung: Lung Injury in Patients with Brain Injury

• Jeong JH

• KMID: 2385879
• DOI: http://doi.org/10.18700/jnc.170009

Abstract

Neurocritically ill patients are at an increased risk of other organ dysfunctions, especially lung injury. Major pulmonary complications, including acute respiratory distress syndrome, ventilator-associated pneumonia, and neurogenic pulmonary edema, are frequently caused by brain injury, and are associated with poor outcome. Brain and lung have strong interactions via complex pathways from the brain to the lung, and vice versa. Excessive release of catecholamines and systemic inflammatory responses play an integral role in the development of pulmonary dysfunction after brain injuries. Mechanical ventilation is commonly used to manage pulmonary dysfunctions associated with brain injury, and lung protective ventilation strategies reduce injuries to the lung and brain. This review focuses on the current knowledge regarding the epidemiology and pathophysiology of lung injuries in patients with neurocritical illness, and the various strategies of mechanical ventilation used to reduce lung injury.

Keyword

Brain injury; Lung injury; Epidemiology; Pathophysiology; Mechanical ventilation

MeSH Terms

Brain Injuries*
Brain*
Catecholamines
Epidemiology
Humans
Lung Injury*
Lung*
Pneumonia, Ventilator-Associated
Pulmonary Edema
Respiration, Artificial
Respiratory Distress Syndrome, Adult
Ventilation
Catecholamines

Figure

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  Figure 1. Interactions between the brain and the lung in patients with neurocritical illness.

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  Figure 2. Pathophysiology of lung injuries in patients with brain injury: the Double Hit Model.

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