Acute and Critical Care

Review Article

Neurosurgery
Brain-lung interaction: a vicious cycle in traumatic brain injury: Ariana Alejandra Chacón-Aponte, Érika Andrea Durán-Vargas, Jaime Adolfo Arévalo-Carrillo, Iván David Lozada-Martínez, Maria Paz Bolaño-Romero, Luis Rafael Moscote-Salazar, Pedro Grille, Tariq Janjua; Acute Crit Care. 2022;37(1):35-44. Published online February 11, 2022; DOI: https://doi.org/10.4266/acc.2021.01193

16,114 View
939 Download
15 Web of Science
18 Crossref

The brain-lung interaction can seriously affect patients with traumatic brain injury, triggering a vicious cycle that worsens patient prognosis. Although the mechanisms of the interaction are not fully elucidated, several hypotheses, notably the “blast injury” theory or “double hit” model, have been proposed and constitute the basis of its development and progression. The brain and lungs strongly interact via complex pathways from the brain to the lungs but also from the lungs to the brain. The main pulmonary disorders that occur after brain injuries are neurogenic pulmonary edema, acute respiratory distress syndrome, and ventilator-associated pneumonia, and the principal brain disorders after lung injuries include brain hypoxia and intracranial hypertension. All of these conditions are key considerations for management therapies after traumatic brain injury and need exceptional case-by-case monitoring to avoid neurological or pulmonary complications. This review aims to describe the history, pathophysiology, risk factors, characteristics, and complications of brain-lung and lung-brain interactions and the impact of different old and recent modalities of treatment in the context of traumatic brain injury.

Citations

Citations to this article as recorded by

Uncertainty in Neurocritical Care: Recognizing Its Relevance for Clinical Decision-Making
Luis Rafael Moscote-Salazar, William A. Florez-Perdomo, Tariq Janjua
Indian Journal of Neurotrauma.2024; 21(01): 092. CrossRef
Manejo postoperatorio de resección de tumores cerebrales en la unidad de cuidado intensivo
Andrés Felipe Naranjo Ramírez, Álvaro de Jesús Medrano Areiza, Bryan Arango Sánchez, Juan Carlos Arango Martínez, Luis Fermín Naranjo Atehortúa
Acta Colombiana de Cuidado Intensivo.2024; 24(2): 140. CrossRef
Effects of positive end-expiratory pressure on intracranial pressure, cerebral perfusion pressure, and brain oxygenation in acute brain injury: Friend or foe? A scoping review
Greta Zunino, Denise Battaglini, Daniel Agustin Godoy
Journal of Intensive Medicine.2024; 4(2): 247. CrossRef
Acute brain injury increases pulmonary capillary permeability via sympathetic activation-mediated high fluid shear stress and destruction of the endothelial glycocalyx layer
Na Zhao, Chao Liu, Xinxin Tian, Juan Yang, Tianen Wang
Experimental Cell Research.2024; 434(2): 113873. CrossRef
Oral administration of lysozyme protects against injury of ileum via modulating gut microbiota dysbiosis after severe traumatic brain injury
Weijian Yang, Caihua Xi, Haijun Yao, Qiang Yuan, Jun Zhang, Qifang Chen, Gang Wu, Jin Hu
Frontiers in Cellular and Infection Microbiology.2024;[Epub] CrossRef
Pulmonary Effects of Traumatic Brain Injury in Mice: A Gene Set Enrichment Analysis
Wei-Hung Chan, Shih-Ming Huang, Yi-Lin Chiu
International Journal of Molecular Sciences.2024; 25(5): 3018. CrossRef
Beyond the brain: General intensive care considerations in pediatric neurocritical care
Thao L. Nguyen, Dennis W. Simon, Yi-Chen Lai
Seminars in Pediatric Neurology.2024; 49: 101120. CrossRef
Research Progress of Hemorrhagic Stroke Combined with Stroke-Associated Pneumonia
松刘
Advances in Clinical Medicine.2024; 14(05): 2336. CrossRef
The Impact of Pulmonary Disorders on Neurological Health (Lung-Brain Axis)
Hongryeol Park, Chan Hee Lee
Immune Network.2024;[Epub] CrossRef
Modeling of the brain-lung axis using organoids in traumatic brain injury: an updated review
Jong-Tae Kim, Kang Song, Sung Woo Han, Dong Hyuk Youn, Harry Jung, Keun-Suh Kim, Hyo-Jung Lee, Ji Young Hong, Yong-Jun Cho, Sung-Min Kang, Jin Pyeong Jeon
Cell & Bioscience.2024;[Epub] CrossRef
Ventilatory targets following brain injury
Shaurya Taran, Sarah Wahlster, Chiara Robba
Current Opinion in Critical Care.2023; 29(2): 41. CrossRef
Targeted Nanocarriers Co-Opting Pulmonary Intravascular Leukocytes for Drug Delivery to the Injured Brain
Jia Nong, Patrick M. Glassman, Jacob W. Myerson, Viviana Zuluaga-Ramirez, Alba Rodriguez-Garcia, Alvin Mukalel, Serena Omo-Lamai, Landis R. Walsh, Marco E. Zamora, Xijing Gong, Zhicheng Wang, Kartik Bhamidipati, Raisa Y. Kiseleva, Carlos H. Villa, Colin F
ACS Nano.2023; 17(14): 13121. CrossRef
Modulation of MAPK/NF-κB Pathway and NLRP3 Inflammasome by Secondary Metabolites from Red Algae: A Mechanistic Study
Asmaa Nabil-Adam, Mohamed L. Ashour, Mohamed Attia Shreadah
ACS Omega.2023; 8(41): 37971. CrossRef
American Association for the Surgery of Trauma/American College of Surgeons Committee on Trauma clinical protocol for management of acute respiratory distress syndrome and severe hypoxemia
Jason A. Fawley, Christopher J. Tignanelli, Nicole L. Werner, George Kasotakis, Samuel P. Mandell, Nina E. Glass, David J. Dries, Todd W. Costantini, Lena M. Napolitano
Journal of Trauma and Acute Care Surgery.2023; 95(4): 592. CrossRef
The role of cardiac dysfunction and post-traumatic pulmonary embolism in brain-lung interactions following traumatic brain injury
Mabrouk Bahloul, Karama Bouchaala, Najeh Baccouche, Kamilia Chtara, Hedi Chelly, Mounir Bouaziz
Acute and Critical Care.2022; 37(2): 266. CrossRef
Allocation of Donor Lungs in Korea
Hye Ju Yeo
Journal of Chest Surgery.2022; 55(4): 274. CrossRef
Mapping brain endophenotypes associated with idiopathic pulmonary fibrosis genetic risk
Ali-Reza Mohammadi-Nejad, Richard J. Allen, Luke M. Kraven, Olivia C. Leavy, R. Gisli Jenkins, Louise V. Wain, Dorothee P. Auer, Stamatios N. Sotiropoulos
eBioMedicine.2022; 86: 104356. CrossRef
Use of bedside ultrasound in the evaluation of acute dyspnea: a comprehensive review of evidence on diagnostic usefulness
Ivan David Lozada-Martinez, Isabela Zenilma Daza-Patiño, Gerardo Jesus Farley Reina-González, Sebastián Rojas-Pava, Ailyn Zenith Angulo-Lara, María Paola Carmona-Rodiño, Olga Gissela Sarmiento-Najar, Jhon Mike Romero-Madera, Yesid Alonso Ángel-Hernandez
Revista Investigación en Salud Universidad de Boyacá.2022;[Epub] CrossRef

Case Reports

Delayed Onset Contralateral Reexpansion Pulmonary Edema after Tension Pneumothorax: A Case Report: Dongseop Song, Jai Yun Jung; Korean J Crit Care Med. 2013;28(2):137-140.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.137

2,458 View
19 Download

Abstract PDF: A 16-year-old male patient presented with left side chest pain. The initial chest radiograph showed tension pneumohtorax on the left side. Air was evacuated by closed thoracostomy. About 72 hours later, during administration of general anesthesia for thoracoscopic bullectomy, unilateral pulmonary edema affecting the contralateral lung developed without definite infiltration in the left lung. The operation was suspended and the patient was admitted to the intensive care unit. A close observation of the patient and conservative therapy were enough to manage this pulmonary edema. This is a very rare manifestation of reexpansion pulmonary edema that is unpredictable and could be fatal. The clinical course is described in this article.

Muscular Rigidity and Pulmonary Edema Following Administration of Low Dose Fentanyl: A Case Report: Sung Kyu Rim, Jong Il Kim, Yu Bin Son, Ji Heui Lee; Korean J Crit Care Med. 2012;27(3):197-201.; DOI: https://doi.org/10.4266/kjccm.2012.27.3.197

3,735 View
41 Download
1 Crossref

Abstract PDF

Fentanyl-induced muscular rigidity has been reported exclusively in patients when large fentanyl dosages were employed in the operating room or in the pediatric intensive care unit. Rigidity and pulmonary edema after analgesic doses of fentanyl had not been reported previously. A 25-year-old man underwent removal of a foreign body and application of an Ilizarov frame of tibia under general anesthesia. The patient received 100 microg of fentanyl during emergence of anesthesia and the procedure of dressing. On arrival to the anesthetic recovery room, the patient presented with muscular rigidity and about 1 hour later, developed pulmonary edema. The notable predisposing factors were rapid injection of fentanyl and history of treatment with antidepressants and haloperidol, modifiers of serotonin and dopamine levels. From this case, we suggest the need for careful observation for the development of muscle rigidity complicating airway management in patients taking antidepressants and antipsychotics, especially after administration of an analgesic dose of fentanyl.

Citations

Citations to this article as recorded by

Recurrent Desaturation Events due to Opioid-Induced Chest Wall Rigidity after Low Dose Fentanyl Administration
Sung Yeon Ham, Bo Ra Lee, Taehoon Ha, Jeongmin Kim, Sungwon Na
Korean Journal of Critical Care Medicine.2016; 31(2): 118. CrossRef

Ipsilateral Reexpansion Pulmonary Edema Developed after Decortication: A Case Report: Kyoung Hun Kim, Mi Rang Bang, Myong Su Chon, Jae Hang Shim, Woo Jae Jeon, Sang Yoon Cho, Woo Jong Shin, Jong Hoon Yeom; Korean J Crit Care Med. 2010;25(4):266-270.; DOI: https://doi.org/10.4266/kjccm.2010.25.4.266

2,406 View
14 Download

Abstract PDF: Reexpansion pulmonary edema (RPE) is a rare but sometimes fatal complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. We experienced a case of RPE that developed following decortication. A 46 year-old female had a decortication for pyothorax under one-lung anesthesia. There was no event during the operation and results of arterial blood gas analysis were within normal limits. After the operation, tracheal extubation was performed and 100% oxygen saturation on a pulse oximeter (SpO2) was maintained with 100% O2, (8 L/min) via mask ventilation with self-respiration. The patient, with 50% Venturi mask, was transported to the intensive care unit (ICU). On arrival at the ICU, a SpO2 of 80% was detected and arterial blood gas analysis revealed hypoxemia with acute hypercapnic respiratory acidosis. Fortunately, reexpansion pulmonary edema was detected early and intensive treatment was performed using mechanical ventilation with positive end-expiratory pressure. Tracheal extubation was performed after 1 day of mechanical ventilation. The reexpansion pulmonary edema was successfully treated and the patient recovered without any complications.

Reexpansion Pulmonary Edema Following the Early Decompression of Pneumothorax Occurred after Anesthetic Induction in a Patient with Lung Bulla: A Case Report: Hye Jin Jeung, Hyun Jung Lee, Seok Jai Kim, Sang Hyun Kwak; Korean J Crit Care Med. 2010;25(3):159-162.; DOI: https://doi.org/10.4266/kjccm.2010.25.3.159

2,462 View
16 Download

Abstract PDF: When a rapidly re-expanding lung has been in a state of collapse for more than several days, pulmonary edema sometimes occurs. This is called reexpansion pulmonary edema. In general, it most commonly occurs in patients with a large pneumothorax of long duration. In this case, a 15 year old female patient with a 2.3 cm sized bulla in the right lung developed right pneumothorax after anesthetic induction. Although early drainage by closed thoracostomy was performed, right pulmonary edema eventually occurred. It is unusual that vigorous reexpansion pulmonary edema developed even though early decompression was performed within one hour after development of pneumothorax.

Negative Pressure Pulmonary Edema and Hemorrhage after Extubation: A Case Report: Yoon Suk Ra, Chi Hyo Kim, Jong In Han, Dong Yeon Kim; Korean J Crit Care Med. 2010;25(2):98-103.; DOI: https://doi.org/10.4266/kjccm.2010.25.2.98

2,727 View
25 Download
1 Crossref

Abstract PDF

Negative pressure pulmonary edema (NPPE) is a rare complication of acute airway obstruction which develops after endotracheal extubation. The proposed mechanism is generation of very low negative pressure during laryngospasm by inspiratory efforts, which leads to alveolar exudation and hemorrhage. The diagnosis of NPPE is confirmed by clinical findings of tachypnea, pink prothy sputum in the endotracheal tube, hypoxemia on arterial blood gas analysis, and distinctive radiologic findings. NPPE is usually self-limited within 48 hours when diagnosed early and treated appropriately. We report three patients who recovered from NPPE without complications.

Citations

Citations to this article as recorded by

Negative pressure pulmonary edema after endotracheal tube extubation during recovery of general anesthesia in a pediatric patient with cerebral palsy
Hyun Jung Kim, Sun Kyung Park
Allergy, Asthma & Respiratory Disease.2022; 10(4): 229. CrossRef

Neurogenic-stunned Myocardium and Pulmonary Edema Following a Ruptured Cerebral Aneurysm: A Case Report: Sung Ha Mun, Won Joon Choi, Jeong Min Mok, Jae Young Yang, Chul Ho Woo; Korean J Crit Care Med. 2010;25(2):93-97.; DOI: https://doi.org/10.4266/kjccm.2010.25.2.93

2,520 View
22 Download
1 Crossref

Abstract PDF

We report a case of neurogenic cardiopulmonary instability with pulmonary edema occurring after an aneurysmal subarachnoid hemorrhage. The patient's pre-operative Glasgow coma scale score was 6 and the PA chest radiograph showed increased diffuse haziness in the right lung field. The patient presented with severe hypotension and low oxygen saturation during surgery. Cardiac damage was documented by increased CK-MB troponin-T levels, and ischemic ECG findings. Reversible cardiac failure associated with subarachnoid hemorrhage may be due to a neurogenic-stunned myocardium. The patient underwent clipping of the aneurysm and recovered with minimal neurologic impairment and normal cardiac function.

Citations

Citations to this article as recorded by

A Retrospective Study about Characteristics of Out-of-hospital Cardiac Arrest Caused by Non-traumatic Subarachnoid Hemorrhage
Min Seob Sim, Ki Dong Sung, Mun Ju Kang, Ji Ung Na, Tae Gun Shin, Ik Joon Jo, Hyoung Gon Song, Keun Jeong Song, Yeon Kwon Jeong
The Korean Journal of Critical Care Medicine.2011; 26(3): 151. CrossRef

Dilutional Hyponatremia during Hysteroscopic Myomectomy: A Case Report: Si Young Ok, Seung Hwa Ryoo, Young Hee Baek, Sang Ho Kim; Korean J Crit Care Med. 2009;24(2):102-105.; DOI: https://doi.org/10.4266/kjccm.2009.24.2.102

2,387 View
18 Download

Abstract PDF: Hysteroscopy is utilized for making the diagnosis and treating a series of uterine disease. It's advantages are more accurate removal of lesion, a short operating time, low morbidity and rapid postoperative recovery. However, serious complications can happen following hysteroscopic surgery. The complications can be divided into the procedure-related, media-related and postoperative events. The procedure-related complications include cervical laceration, uterine perforation, bowel and bladder injury, and hemorrhage. The media-related complications include hyponatremia, gas embolism and excessive fluid absorption. The postoperative events include endometritis and postoperative synechiae. We experienced hyponatermia with pulmonary edema due to excessive fuid absorption in a 52-year-old woman who underwent elective hysteroscopic myomectomy under general anesthesia. She was treated with oxygen therapy, normal saline and furosemide and she recovered without sequelae.

Acute Pulmonary Edema after Cardioversion for Torsade de Pointes:A Case Report: Na Rae Ha, Duk Joo Lee, Tae Hyung Kim, Ho Joo Yoon, Dong Ho Shin, Jang Won Sohn, Sung Soo Park; Korean J Crit Care Med. 2007;22(1):52-56.

1,881 View
19 Download

Abstract PDF: Cardioversion used for the treatment of various cardiac arrhythmias is a safe and effective procedure with infrequent complication. The restoration of sinus rhythm is followed by a improvement in hemodynamics, but acute pulmonary edema has been reported as a rare complication following successful electrical reversion of various tachyarrhythmia to normal sinus rhythm. This report describes a 42-year-old woman with a history of schizophrenia who experienced pulmonary edema after cardioversion for torsade de pointes. She had taken chlorpromazine and haloperidol for schizophrenia. The antipsychotic drugs were suspected to induce QT interval prolongation and resultant torsade de pointes. Two hours after cardioversion, pulmonary edema developed on chest X-ray and chest computed tomography. She responded to conservative treatment including oxygen therapy and the pulmonary edema improved on the second hospital day. The mechanism of pulmonary edema after cardioversion is still uncertain and remains controversial.

A Case of Pulmonary Edema which Developed after Difficult Endotracheal Intubation of Hunter Syndrome: A Case Report: Ha Jin Kim, Seok Hwa Yoon, Yoon Hee Kim, Hee Suk Yoon; Korean J Crit Care Med. 2005;20(2):187-191.

1,639 View
33 Download

Abstract PDF: Hunter syndrome is one of the mucopolysaccharidoses, characterized by abnormal accumulation and deposition of mucopolysaccharides in the tissues of several organs which are known to complicate anaesthetic and airway management. We experienced a case of pulmonary edema which developed during induction of general anesthesia of Hunter syndrome after several attempts of intubation and airway obstruction.

Acute Pulmonary Edema following Failed Intubation: A Case Report: Youn Jung Park, Dong Hee Woo, Rim Soo Won, Young Ryong Choi, Mi Hwa Chung; Korean J Crit Care Med. 2005;20(1):82-86.

1,951 View
59 Download

Abstract PDF: Pulmonary edema that follows upper airway obstruction may occur in a variety of clinical situations. Post anesthetic laryngospasm has been implicated as the most frequent cause of this syndrome. Risk factors for development of post laryngospasm pulmonary edema include difficult intubation; nasal, oral, or pharyngeal surgical site; and obesity with obstructive apnea. We report a case that developed acute bilateral pulmonary edema after laryngospasm induced by failed intubation.

Chest Compression for Post Obstructive Pulmonary Edema: A Case Report: Hee Wan Moon; Korean J Crit Care Med. 2004;19(1):57-60.

1,694 View
12 Download

Abstract PDF: Post obstructive pulmonary edema (POPE) after anesthesia is a rare, but potentially dangerous pulmonary edema during or after relief of severe total or partial upper airway obstruction. The formation of POPE is believed to be the generation of negative intrapleural and intraalveolar pressures which increase the pulmonary transvascular hydrostatic pressure gradient and cause fluid movement to the interstitium and alveoli. Because of both the rapidity and severity with which POPE can develop, prompt recognition and management are essential. A case of POPE after anesthesia in a 23 year-old healthy male undergoing the primary repair of T12 fracture was presented. The patient was extubated without problem after operation. Arrived at the ICU, the patient showed laryngospasm and low oxygen saturation (around 50%). After the intubation with PEEP and the suction of the big amount of pinky frothy transudates through endotracheal tube, oxygen saturation was kept mid 70 s for over 30 minutes. After about 10 times chest compression with suctioning through endotracheal tube, the patient's oxygen saturation showed mid 90 s. This chest compression for the POPE was not recognized by the reference. Even though I can not tell the advantage or disadvantage of this treatment, I report this case for the future reference. After reviewing the reference, the risk factors, differential diagnosis, management and prevention of POPE are discussed.

Original Article

Influence of Collapse and Re-ventilation of Lung on the Development of Pulmonary Edema: Sang Hyun Kwak, Won Jong Jin, Hong Beom Bae, Seong Wook Jeong, Sung Su Chung, Chang Young Jeong; Korean J Crit Care Med. 2004;19(1):8-19.

1,950 View
15 Download

Abstract PDF: BACKGROUND
This study was to clarify the influence of collapse and re-ventilation of lung on the development of pulmonary edema in rabbit. METHODS: Animals were randomly assigned to one of three groups: Sham group receiving two lung ventilation (n=14), Collapse group receiving collapse of right lung (n=14), Reventilation group receiving collapse of right lung for 3 hours followed by reventilation of collapsed right lung for 3 hours (n=14). The lung of rabbits were ventilated with 50% oxygen through the tracheostomy. Right main bronchus was secured by thoracotomy in all animal. Collapse and reventilation were performed using by bulldog forcep. Mean arterial pressure, heart rate, arterial oxygen tension (PaO2), peripheral blood leukocyte and platelet counts were recorded at 0, 1, 2, 3, 4, 5 and 6 hour after the start of experiment. The wet to dry (W/D) weight ratio of lung, lung injury score and leukocyte counts, percentage of polymorphonuclear leukocyte (PMNL), concentration of albumin, and interleukin-8 (IL-8) in bronchoalveolar lavage fluid (BALF) were measured 6 hour after the start of experiment in both lung. RESULTS: W/D weight ratio of lung, lung injury score and leukocyte counts, percentage of PMNL, concentration of albumin and IL-8 in BALF were significantly increased in both lung of reventilation group. And the degree of increases is more significant in right than left lung. CONCLUSIONS: These findings suggest that reventilation of collapsed lung causes the bilateral pulmonary edema in rabbit mainly by activating neutrophil and IL-8 responses, which may play a central role in non cardiogenic pulmonary edema.

Case Reports

Pulmonary Edema due to Upper Airway Obstruction after Neck Mass Excision of the Patient with Cerebral Palsy: Moon Seok Chang, Hun Cho, Hae Ja Lim, Seong Ho Chang, Nan Suk Kim; Korean J Crit Care Med. 1997;12(2):183-186.

1,468 View
7 Download

Abstract PDF: Because the emergence from anesthesia may be delayed in the patient with the cerebral palsy, extubation must be delayed until consciousness is recovered completely. Postoperative pulmonary edema has several causes and one of them, upper airway obstruction is rare. We had experienced pulmonary edema due to upper airway obstruction after neck mass excision in the patient with cerebral palsy, who was 21-year-old, 50 kg, male and normal preoperative laboratory data. There was no significant change in blood volume during operation for 1 hour. After operation, the patient breathed spontaneously and the endotracheal tube was extubated in the operating room. When the patient was transfered to the recovery room, he had cyanosis, intercostal and substernal retraction, and the pulse oximeter showed very low oxygen saturation. We supplied oxygen to the patient and reintubated him, and recognized the pinkish frothy sputum by suction of the endotracheal tube. On the portable chest X-ray film of the patient at the moment, hazy increased density on both lung fields indicating pulmonary edema, but the heart size was not increased. By routine treatment for pulmonary edema, the symtoms and signs of the patient were improved. He had stayed for 1 day in the SICU and then transfered to the general ward.

Anesthesia for Cesarean Section in Two Pregnant Women with Peripartum Cardiomyopathy: A report of two cases: Yong In Kang, Kyung Sook Cho, Su Yeon Kim, Myoung Hee Kim, Hyun Sook Lee; Korean J Crit Care Med. 1997;12(2):177-182.

1,374 View
23 Download

Abstract PDF: Peripartum cardiomyopathy (PPCM) is defined as the onset of acute heart failure without demonstrable cause in the last trimester of pregnancy or within the first 6 months after delivery. Mortality from PPCM ranges from 25% to 50% and cause of death is usually chronic congestive heart failure or thromboembolic complications. We experienced 2 patients with PPCM. One was a twin pregnant woman and PPCM was developed after cesarean section. In the other case, PPCM was combined with aspiration pneumonia in the preterm labor patient. They were treated with diuretics and cardiotonic drugs and recovered to normal cardiac function within 7 to 10 days. Prognosis is related to recovery of left ventricular function, which usually occurs within 6 months postpartum. Early diagnosis and appropriate treatment of PPCM improve outcome.

First
Prev
Page of 1
Next
Last

Search