The central nervous system during lung injury and mechanical ventilation: a narrative review
Por:
Albaiceta, GM, Brochard, L, Santos, CCD, Fernandez, R, Georgopoulos, D, Girard, T, Jubran, A, Lopez-Aguilar, J, Mancebo, J, Pelosi, P, Skrobik, Y, Thille, AW, Wilcox, ME, Blanch, L
Publicada:
1 oct 2021
Ahead of Print:
1 sep 2021
Resumen:
Mechanical ventilation induces a number of systemic responses for which the brain plays an essential role. During the last decade, substantial evidence has emerged showing that the brain modifies pulmonary responses to physical and biological stimuli by various mechanisms, including the modulation of neuroinflammatory reflexes and the onset of abnormal breathing patterns. Afferent signals and circulating factors from injured peripheral tissues, including the lung, can induce neuronal reprogramming, potentially contributing to neurocognitive dysfunction and psychological alter-ations seen in critically ill patients. These impairments are ubiquitous in the presence of positive pressure ventilation. This narrative review summarises current evidence of lung-brain crosstalk in patients receiving mechanical ventilation and describes the clinical implications of this crosstalk. Further, it proposes directions for future research ranging from identifying mechanisms of multiorgan failure to mitigating long-term sequelae after critical illness.
Filiaciones:
Albaiceta, GM:
Hosp Univ Cent Asturias, Unidad Cuidados Intens Cardiol, Oviedo, Spain
Univ Oviedo, Inst Univ Oncol Principado Asturias, Dept Biol Func, Oviedo, Spain
Inst Invest Sanitaria Principado Asturias, Oviedo, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp CIBER Enf, Madrid, Spain
Brochard, L:
St Michaels Hosp, Li Ka Shing Knowledge Inst, Keenan Res Ctr, Toronto, ON, Canada
Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada
Santos, CCD:
St Michaels Hosp, Li Ka Shing Knowledge Inst, Keenan Res Ctr, Toronto, ON, Canada
Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada
Fernandez, R:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp CIBER Enf, Madrid, Spain
Althaia Xarxa Assistencial Univ Manresa, Univ Int Catalunya, Crit Care Dept, Manresa, Spain
Georgopoulos, D:
Univ Crete, Sch Med, Univ Hosp Heraklion, Intens Care Med Dept, Iraklion, Crete, Greece
Girard, T:
Univ Pittsburgh, Sch Med, Dept Crit Care Med, Clin Res Invest & Syst Modeling Acute Illnes CRIS, Pittsburgh, PA USA
Jubran, A:
Hines VA Hosp, Div Pulm & Crit Care Med, Hines, IL USA
Loyola Univ Chicago, Stritch Sch Med, Maywood, IL USA
Lopez-Aguilar, J:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp CIBER Enf, Madrid, Spain
Univ Autonoma Barcelona, Inst Invest & Innovac Parc Tauli I3PT, Hosp Univ Parc Tauli, Crit Care Ctr, Sabadell, Spain
Mancebo, J:
Univ Hosp St Pau, Serv Med Intens, Barcelona, Spain
Pelosi, P:
Univ Genoa, Dept Surg Sci & Integrated Diagnost, Genoa, Italy
San Martino Policlin Hosp, IRCCS Oncol & Neurosci, Anesthesia & Intens Care, Genoa, Italy
Skrobik, Y:
McGill Univ, Dept Med, Regrp Soins Crit Resp, Reseau Soins Resp FRQS, Montreal, PQ, Canada
Thille, AW:
CHU Poitiers, Med Intens Reanimat, Poitiers, France
Univ Poitiers, INSERM, CIC 1402 ALIVE, Poitiers, France
Wilcox, ME:
Univ Hlth Network, Div Respirol Crit Care Med, Dept Med, Toronto, ON, Canada
Blanch, L:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp CIBER Enf, Madrid, Spain
Univ Autonoma Barcelona, Inst Invest & Innovac Parc Tauli I3PT, Hosp Univ Parc Tauli, Crit Care Ctr, Sabadell, Spain
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