Ventilación mecánica en el paciente con lesión cerebral aguda

In about20% of patients admitted to an Intensive Care Unit (ICU) the indica-tion of mechanical ventilation (MV) is a neurological disease. These patients have a prolonged MV stay and high mortality. The appropriate use of MV in patients with acute brain injury (ABI) is critica! considering that MV b...

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Autores principales:	Tomicic F,Vinko, Andresen H,Max
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2011
Materias:	Brain injuries Intensive care units Positive-pressure ventilation
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872011000300016
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spelling	oai:scielo:S0034-988720110003000162011-08-25Ventilación mecánica en el paciente con lesión cerebral agudaTomicic F,VinkoAndresen H,Max Brain injuries Intensive care units Positive-pressure ventilation In about20% of patients admitted to an Intensive Care Unit (ICU) the indica-tion of mechanical ventilation (MV) is a neurological disease. These patients have a prolonged MV stay and high mortality. The appropriate use of MV in patients with acute brain injury (ABI) is critica! considering that MV by itself is oble to induce or worsen an underlying lung injury. Patients with ABI have a higher risk to develop pulmonary complications. During endotracheal intubation the activation of airway reflexes should beprevented, because they may increase intracranialpressure. Tracheostomy is indicated to improve airway management and it is performed in about 33% of these patients. Indications for MV are loss of spontaneous respira-tory effort, changes in lung compliance, gas exchange impairment and ventilatory failure due to muscle fatigue or neuromuscular junction dysfunction. During MV, hypoxemia should be avoided. The pC0(2) level has a critica! role in cerebral blood flow regulation; therefore a normal pCO must be maintained in order to guarantee an optimal cerebral blood flow. Despite that, hypocapnia has been used in patients with increased intracranial pressure, at the present it is not recommended. Its use should be limited to the emergency management of intracranial hypertension, while the underlying cause is beingtreated. Non-conventional ventilatory modes asprone position ventilation, high-frequency oscillatory ventilation and extracorporeal C02 removal can be used in patients with ABI. All ofthem have specific risks and should be employed cautiously This paper reviews upper airway management and MV in patients with acute brain injury.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.139 n.3 20112011-03-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872011000300016es10.4067/S0034-98872011000300016
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Brain injuries Intensive care units Positive-pressure ventilation
spellingShingle	Brain injuries Intensive care units Positive-pressure ventilation Tomicic F,Vinko Andresen H,Max Ventilación mecánica en el paciente con lesión cerebral aguda
description	In about20% of patients admitted to an Intensive Care Unit (ICU) the indica-tion of mechanical ventilation (MV) is a neurological disease. These patients have a prolonged MV stay and high mortality. The appropriate use of MV in patients with acute brain injury (ABI) is critica! considering that MV by itself is oble to induce or worsen an underlying lung injury. Patients with ABI have a higher risk to develop pulmonary complications. During endotracheal intubation the activation of airway reflexes should beprevented, because they may increase intracranialpressure. Tracheostomy is indicated to improve airway management and it is performed in about 33% of these patients. Indications for MV are loss of spontaneous respira-tory effort, changes in lung compliance, gas exchange impairment and ventilatory failure due to muscle fatigue or neuromuscular junction dysfunction. During MV, hypoxemia should be avoided. The pC0(2) level has a critica! role in cerebral blood flow regulation; therefore a normal pCO must be maintained in order to guarantee an optimal cerebral blood flow. Despite that, hypocapnia has been used in patients with increased intracranial pressure, at the present it is not recommended. Its use should be limited to the emergency management of intracranial hypertension, while the underlying cause is beingtreated. Non-conventional ventilatory modes asprone position ventilation, high-frequency oscillatory ventilation and extracorporeal C02 removal can be used in patients with ABI. All ofthem have specific risks and should be employed cautiously This paper reviews upper airway management and MV in patients with acute brain injury.
author	Tomicic F,Vinko Andresen H,Max
author_facet	Tomicic F,Vinko Andresen H,Max
author_sort	Tomicic F,Vinko
title	Ventilación mecánica en el paciente con lesión cerebral aguda
title_short	Ventilación mecánica en el paciente con lesión cerebral aguda
title_full	Ventilación mecánica en el paciente con lesión cerebral aguda
title_fullStr	Ventilación mecánica en el paciente con lesión cerebral aguda
title_full_unstemmed	Ventilación mecánica en el paciente con lesión cerebral aguda
title_sort	ventilación mecánica en el paciente con lesión cerebral aguda
publisher	Sociedad Médica de Santiago
publishDate	2011
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872011000300016
work_keys_str_mv	AT tomicicfvinko ventilacionmecanicaenelpacienteconlesioncerebralaguda AT andresenhmax ventilacionmecanicaenelpacienteconlesioncerebralaguda
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Ventilación mecánica en el paciente con lesión cerebral aguda

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