Neurocritically ill
patients are at an increased
risk of other organ dysfunctions, especially
lung injury. Major pulmonary
complications, including
acute respiratory distress syndrome,
ventilator-associated pneumonia, and neurogenic
pulmonary edema, are frequently caused by
brain injury, and are associated with poor outcome.
Brain and
lung have strong interactions via complex pathways from the
brain to the
lung, and vice versa. Excessive release of
catecholamines and systemic inflammatory responses
play an integral
role in the development of pulmonary dysfunction after
brain injuries.
Mechanical ventilation is commonly used to manage pulmonary dysfunctions associated with
brain injury, and
lung protective
ventilation strategies reduce
injuries to the
lung and
brain. This
review focuses on the current
knowledge regarding the
epidemiology and pathophysiology of
lung injuries in
patients with neurocritical illness, and the various
strategies of
mechanical ventilation used to reduce
lung injury.