Ventilatory support in patients with acute disease of the central nervous system
Bugedo, G.; Castillo, L.; Hernández, G.
Revista Medica de Chile 127(2): 211-221
1999
ISSN/ISBN: 0034-9887 PMID: 10436703 Document Number: 510066
Patients with severe head injury are prone to pulmonary complications that result in hypoxemia or hypercarbia, which could worsen their neurological condition. A rational ventilatory approach requires a good knowledge of respiratory and neurological pathophysiology. Airway management is of prime importance in neurological patients. Prophylactic chronic hyperventilation in head trauma is no longer recommended since it could impair cerebral perfusion, although transient hypocarbia could be of benefit to some patients. The use of low or moderate positive and expiratory pressure levels apparently improves oxygenation without worsening intracranial pressure. Ventilatory management should be closely monitored and adjusted to hemodynamic, respiratory and neurological status to achieve a good outcome.