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Combined lung and brain ultrasonography for an individualized “brain-protective ventilation strategy” in neurocritical care patients with challenging ventilation needs

Overview of attention for article published in The Ultrasound Journal, September 2018
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Title
Combined lung and brain ultrasonography for an individualized “brain-protective ventilation strategy” in neurocritical care patients with challenging ventilation needs
Published in
The Ultrasound Journal, September 2018
DOI 10.1186/s13089-018-0105-4
Pubmed ID
Authors

Francesco Corradi, Chiara Robba, Guido Tavazzi, Gabriele Via

Abstract

When intracranial hypertension and severe lung damage coexist in the same clinical scenario, their management poses a difficult challenge, especially as concerns mechanical ventilation management. The needs of combined lung and brain protection from secondary damage may conflict, as ventilation strategies commonly used in patients with ARDS are potentially associated with an increased risk of intracranial hypertension. In particular, the use of positive end-expiratory pressure, recruitment maneuvers, prone positioning, and protective lung ventilation can have undesirable effects on cerebral physiology: they may positively or negatively affect intracranial pressure, based on the final repercussions on PaO2 and cerebral perfusion pressure (through changes in cardiac output, mean arterial pressure, venous return, PaO2 and PaCO2), also according to the baseline conditions of cerebral autoregulation. Lung ultrasound (LUS) and brain ultrasound (BUS, as a combination of optic nerve sheath diameter assessment and cerebrovascular Doppler ultrasound) have independently proven their potential in respectively monitoring lung aeration and brain physiology at the bedside. In this narrative review, we describe how the combined use of LUS and BUS on neurocritical patients with demanding mechanical ventilation needs can contribute to ventilation management, with the aim of a tailored "brain-protective ventilation strategy."

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The data shown below were compiled from readership statistics for 73 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 73 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 12 16%
Other 9 12%
Student > Postgraduate 7 10%
Professor > Associate Professor 5 7%
Student > Doctoral Student 4 5%
Other 18 25%
Unknown 18 25%
Readers by discipline Count As %
Medicine and Dentistry 39 53%
Nursing and Health Professions 4 5%
Neuroscience 3 4%
Computer Science 1 1%
Immunology and Microbiology 1 1%
Other 4 5%
Unknown 21 29%