首页> 美国卫生研究院文献>Critical Ultrasound Journal >Combined lung and brain ultrasonography for an individualized brain-protective ventilation strategy in neurocritical care patients with challenging ventilation needs
【2h】

Combined lung and brain ultrasonography for an individualized brain-protective ventilation strategy in neurocritical care patients with challenging ventilation needs

机译:结合肺部和脑部超声检查为需要通气的神经危重患者提供个性化的脑保护通气策略

代理获取
本网站仅为用户提供外文OA文献查询和代理获取服务,本网站没有原文。下单后我们将采用程序或人工为您竭诚获取高质量的原文,但由于OA文献来源多样且变更频繁,仍可能出现获取不到、文献不完整或与标题不符等情况,如果获取不到我们将提供退款服务。请知悉。

摘要

When intracranial hypertension and severe lung damage coexist in the same clinical scenario, their management poses a difficult challenge, especially as concerns mechanical ventilation management. The needs of combined lung and brain protection from secondary damage may conflict, as ventilation strategies commonly used in patients with ARDS are potentially associated with an increased risk of intracranial hypertension. In particular, the use of positive end-expiratory pressure, recruitment maneuvers, prone positioning, and protective lung ventilation can have undesirable effects on cerebral physiology: they may positively or negatively affect intracranial pressure, based on the final repercussions on PaO2 and cerebral perfusion pressure (through changes in cardiac output, mean arterial pressure, venous return, PaO2 and PaCO2), also according to the baseline conditions of cerebral autoregulation. Lung ultrasound (LUS) and brain ultrasound (BUS, as a combination of optic nerve sheath diameter assessment and cerebrovascular Doppler ultrasound) have independently proven their potential in respectively monitoring lung aeration and brain physiology at the bedside. In this narrative review, we describe how the combined use of LUS and BUS on neurocritical patients with demanding mechanical ventilation needs can contribute to ventilation management, with the aim of a tailored “brain-protective ventilation strategy.”
机译:当颅内高压和严重肺损伤并存于同一临床情况时,其管理就面临着艰巨的挑战,尤其是在机械通气管理方面。肺部和脑部综合保护免受继发性损伤的需求可能会冲突,因为ARDS患者常用的通气策略可能会增加颅内高压的风险。尤其是,使用呼气末正压,募集动作,俯卧位和保护性肺通气会对脑部生理产生不良影响:根据最终对PaO2和脑灌注压的影响,它们可能对颅内压产生正面或负面影响。 (通过心输出量,平均动脉压,静脉回流,PaO2和PaCO2的变化),也根据脑自动调节的基线条件。肺部超声(LUS)和脑部超声(BUS,结合视神经鞘管直径评估和脑血管多普勒超声)已独立证明了它们分别在床边监测肺通气和脑部生理的潜力。在本篇叙事性综述中,我们描述了LUS和BUS在有机械通气需求的神经危重患者中的联合使用如何有助于通气管理,目的是制定量身定制的“脑保护通气策略”。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
代理获取

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号