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Chapter 26 - Pulmonary Consult: Management of Severe Hypoxia in the Neurocritical Care Unit

Published online by Cambridge University Press:  24 July 2019

By
Rafael A. Calderón Candelario ,
Matthew C. Exline  and
Naeem A. Ali
Edited by
Michel T. Torbey
Michel T. Torbey
Affiliation:
Ohio State University
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Summary

Acute respiratory dysfunction is one of the most frequent medical complications of critically ill patients, including those suffering from neurological diseases. It contributes the highest percentage of mortality from non-neurologic causes in neurocritically ill patients [1–3]. This chapter will focus on the mechanisms, diagnostic criteria, stratification of severity, and management of hypoxemia with attention to acute respiratory distress syndrome (ARDS) in the context of the neurocritically ill. Special consideration will be provided as well to other commonly encountered diseases in the intensive care unit (ICU) such as chronic obstructive pulmonary disease (COPD), and venous thromboembolism.

Type
Chapter
Information
Neurocritical Care , pp. 324 - 334
Publisher: Cambridge University Press
Print publication year: 2019

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References

Reinprecht, A, Greher, M, Wolfsberger, S, et al. (2003). Prone position in subarachnoid hemorrhage patients with acute respiratory distress syndrome: effects on cerebral tissue oxygenation and intracranial pressure. Crit Care Med, 31(6): 1831–1838.CrossRefGoogle ScholarPubMed
Solenski, NJ, Haley, EC Jr., Kassell, NF, et al. (1995). Medical complications of aneurysmal subarachnoid hemorrhage: a report of the multicenter, cooperative aneurysm study. Participants of the Multicenter Cooperative Aneurysm Study. Crit Care Med, 23(6): 1007–1017.Google Scholar
Gruber, A, Reinprecht, A, Illievich, UM, et al. (1999). Extracerebral organ dysfunction and neurologic outcome after aneurysmal subarachnoid hemorrhage. Crit Care Med, 27(3): 505–514.Google Scholar
Bernard, GR, Artigas, A, Brigham, KL, et al. (1994). The American-European Consensus Conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med, 149(3 Pt 1): 818–824.Google Scholar
Force, ADT, Ranieri, VM, Rubenfeld, GD, et al. (2012). Acute respiratory distress syndrome: the Berlin Definition. JAMA, 307(23): 2526–2533.Google Scholar
Villar, J, Perez-Mendez, L, Blanco, J, et al. (2013). A universal definition of ARDS: the PaO2/FiO2 ratio under a standard ventilatory setting: a prospective, multicenter validation study. Intensive Care Med, 39(4): 583–592.Google Scholar
Murray, JF, Matthay, MA, Luce, JM, Flick, MR. (1988). An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis, 138(3): 720–723.Google Scholar
Sheu, CC, Gong, MN, Zhai, R, et al. (2010). Clinical characteristics and outcomes of sepsis-related vs non-sepsis-related ARDS. Chest, 138(3): 559–567.Google Scholar
Kahn, JM, Caldwell, EC, Deem, S, et al. (2006). Acute lung injury in patients with subarachnoid hemorrhage: incidence, risk factors, and outcome. Crit Care Med, 34(1): 196–202.Google Scholar
Veeravagu, A, Chen, YR, Ludwig, C, et al. (2014). Acute lung injury in patients with subarachnoid hemorrhage: a nationwide inpatient sample study. World Neurosurg, 82(1–2): e235–e241.CrossRefGoogle ScholarPubMed
Rincon, F, Ghosh, S, Dey, S, et al. (2012). Impact of acute lung injury and acute respiratory distress syndrome after traumatic brain injury in the United States. Neurosurgery, 71(4): 795–803.Google Scholar
Brower, RG, Matthay, MA, Morris, A, et al.; The Acute Respiratory Distress Syndrome Network. (2000). Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med, 342(18): 1301–1308.Google Scholar
ARDSnet. (2014). Mechanical ventilation protocol summary. www.ardsnet.org/files/ventilator_protocol_2008-07.pdf (accessed December 2018).Google Scholar
Briel, M, Meade, M, Mercat, A, et al. (2010). Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA, 303(9): 865–873.CrossRefGoogle ScholarPubMed
Esteban, A, Alia, I, Gordo, F, et al. (2000). Prospective randomized trial comparing pressure-controlled ventilation and volume-controlled ventilation in ARDS. For the Spanish Lung Failure Collaborative Group. Chest, 117(6): 1690–1696.Google Scholar
Marik, PE, Young, A, Sibole, S, Levitov, A. (2012). The effect of APRV ventilation on ICP and cerebral hemodynamics. Neurocrit Care, 17(2): 219–223.Google Scholar
Jones, GM, Doepker, BA, Erdman, MJ, Kimmons, LA, Elijovich, L. (2013). Predictors of severe hypotension in neurocritical care patients sedated with propofol. Neurocrit Care. 20(2): 270–276.Google Scholar
Muehlschlegel, S, Carandang, R, Ouillette, C, et al. (2013). Frequency and impact of intensive care unit complications on moderate-severe traumatic brain injury: early results of the Outcome Prognostication in Traumatic Brain Injury (OPTIMISM) Study. Neurocrit Care, 18(3): 318–331.Google Scholar
Corral, L, Javierre, CF, Ventura, JL, et al. (2012). Impact of non-neurological complications in severe traumatic brain injury outcome. Crit Care, 16(2): R44.Google Scholar
Ostermann, ME, Keenan, SP, Seiferling, RA, Sibbald, WJ. (2000). Sedation in the intensive care unit: a systematic review. JAMA, 283(11): 1451–1459.Google Scholar
Barr, J, Fraser, GL, Puntillo, K, et al. (2013). Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med, 41(1): 263–306.Google Scholar
Fraser, GL, Devlin, JW, Worby, CP, et al. (2013). Benzodiazepine versus nonbenzodiazepine-based sedation for mechanically ventilated, critically ill adults: a systematic review and meta-analysis of randomized trials. Crit Care Med, 41(9 Suppl 1): S30–S38.Google Scholar
Yang, L, Xu, JM, Jiang, X, et al. (2013). Effect of dexmedetomidine on plasma brain-derived neurotrophic factor: a double-blind, randomized and placebo-controlled study. Ups J Med Sci, 118(4): 235–239.Google Scholar
Soliman, RN, Hassan, AR, Rashwan, AM, Omar, AM. (2011). Prospective, randomized study to assess the role of dexmedetomidine in patients with supratentorial tumors undergoing craniotomy under general anaesthesia. Middle East J Anaesthesiol, 21(3): 325–334.Google Scholar
Soliman, RN, Hassan, AR, Rashwan, AM, Omar, AM. (2011). Prospective, randomized controlled study to assess the role of dexmedetomidine in patients with supratentorial tumors undergoing craniotomy under general anesthesia. Middle East J Anaesthesiol, 21(1): 23–33.Google Scholar
Wiedemann, HP, Wheeler, AP, Bernard, GR, et al. (2006). Comparison of two fluid-management strategies in acute lung injury. N Engl J Med, 354(24): 2564–2575.Google Scholar
Peerless, JR, Snow, N, Likavec, MJ, Pinchak, AC, Malangoni, MA. (1995). The effect of fiberoptic bronchoscopy on cerebral hemodynamics in patients with severe head injury. Chest, 108(4): 962–965.Google Scholar
Kerwin, AJ, Croce, MA, Timmons, SD, et al. (2000). Effects of fiberoptic bronchoscopy on intracranial pressure in patients with brain injury: a prospective clinical study. J Trauma, 48(5): 878–882; discussion 882–883.Google Scholar
Kocaeli, H, Korfali, E, Taskapilioglu, O, Ozcan, T. (2008). Analysis of intracranial pressure changes during early versus late percutaneous tracheostomy in a neuro-intensive care unit. Acta Neurochir (Wien), 150(12): 1263–1267; discussion 1267.Google Scholar
Previgliano, IJ, Ripoll, PI, Chiappero, G, et al. (2002). Optimizing cerebral perfusion pressure during fiberoptic bronchoscopy in severe head injury: effect of hyperventilation. Acta Neurochir (Wien), 81: 103–105.Google Scholar
Guerin, C, Reignier, J, Richard, JC, et al. (2013). Prone positioning in severe acute respiratory distress syndrome. N Engl J Med, 368(23): 2159–2168.Google Scholar
Papazian, L, Forel, JM, Gacouin, A, et al. (2010). Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med, 363(12): 1107–1116.Google Scholar
Sud, S, Sud, M, Friedrich, JO, et al. (2010). High frequency oscillation in patients with acute lung injury and acute respiratory distress syndrome (ARDS): systematic review and meta-analysis. BMJ, 340: c2327.Google Scholar
Young, D, Lamb, SE, Shah, S, et al. (2013). High-frequency oscillation for acute respiratory distress syndrome. N Engl J Med, 368(9): 806–813.Google Scholar
Ferguson, ND, Cook, DJ, Guyatt, GH, et al. (2013). High-frequency oscillation in early acute respiratory distress syndrome. N Engl J Med, 368(9): 795–805.CrossRefGoogle ScholarPubMed
Afshari, A, Brok, J, Moller, AM, Wetterslev, J. (2010). Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) and acute lung injury in children and adults. Cochrane Database Syst Rev, (7): CD002787.Google Scholar
Collins, SR, Blank, RS. (2011). Approaches to refractory hypoxemia in acute respiratory distress syndrome: current understanding, evidence, and debate. Respir Care, 56(10): 1573–1582.Google Scholar
van Heerden, PV, Barden, A, Michalopoulos, N, Bulsara, MK, Roberts, BL. (2000). Dose-response to inhaled aerosolized prostacyclin for hypoxemia due to ARDS. Chest, 117(3): 819–827.Google Scholar
Dunkley, KA, Louzon, PR, Lee, J, Vu, S. (2013). Efficacy, safety, and medication errors associated with the use of inhaled epoprostenol for adults with acute respiratory distress syndrome: a pilot study. Ann Pharmacother, 47(6): 790–796.Google Scholar
Torbic, H, Szumita, PM, Anger, KE, et al. (2013). Inhaled epoprostenol vs inhaled nitric oxide for refractory hypoxemia in critically ill patients. J Crit Care, 28(5): 844–848.Google Scholar
Steinberg, KP, Hudson, LD, Goodman, RB, et al. (2006). Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med, 354(16): 1671–1684.Google Scholar
Guirand, DM, Okoye, OT, Schmidt, BS, et al. (2014). Venovenous extracorporeal life support improves survival in adult trauma patients with acute hypoxemic respiratory failure: a multicenter retrospective cohort study. J Trauma Acute Care Surg, 76(5): 1275–1281.Google Scholar
Petridis, AK, Doukas, A, Kienke, S, et al. (2010). The effect of lung-protective permissive hypercapnia in intracerebral pressure in patients with subarachnoid haemorrhage and ARDS: a retrospective study. Acta Neurochir (Wien), 152(12): 2143–2145.Google Scholar
Junttila, E, Ala-Kokko, T, Ohtonen, P, et al. (2013). Neurogenic pulmonary edema in patients with nontraumatic intracerebral hemorrhage: predictors and association with outcome. Anesth Analg, 116(4): 855–861.Google Scholar
Baumann, A, Audibert, G, McDonnell, J, Mertes, PM. (2007). Neurogenic pulmonary edema. Acta Anaesthesiol Scand, 51(4): 447–455.Google Scholar
Macmillan, CS, Grant, IS, Andrews, PJ. (2002). Pulmonary and cardiac sequelae of subarachnoid haemorrhage: time for active management? Intensive Care Med, 28(8): 1012–1023.Google Scholar
GOLD 2017. From the Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2014). www.goldcopd.org/ (accessed December 2018).Google Scholar
Merli, G. (2005). Diagnostic assessment of deep vein thrombosis and pulmonary embolism. Am J Med, 118(Suppl 8A): 3s–12s.Google Scholar
Tapson, VF, Carroll, BA, Davidson, BL, et al. (1999). The diagnostic approach to acute venous thromboembolism: Clinical practice guideline. American Thoracic Society. Am J Respir Crit Care Med, 160(3): 1043–1066.Google Scholar
Perry, JR. (2012). Thromboembolic disease in patients with high-grade glioma. Neuro Oncol, 14 (Suppl 4): iv73–iv80.Google Scholar
Gould, MK, Garcia, DA, Wren, SM, et al. (2012). Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th edn: American College of Chest Physicians evidence-based clinical practice guidelines. CHEST, 141(2 Suppl): e227S–e277S.CrossRefGoogle Scholar

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