Вестник анестезиологии и реаниматологии (Feb 2018)
NEUROGENIC PULMONARY EDEMA
Abstract
Neurogenic pulmonary edema is one of the complications of acute cerebral diseases and traumas and it is accompanied by severe respiratory failure. It is associated with a high mortality level. There are several theories about neurogenic pulmonary edema development. The theory of the double hit is the most recent causing significant discussion. The theory is based on the pulmonary injury due to systemic inflammatory response when the glial tissue of the injured brain becomes the source of inflammatory mediators. A similar pathogenesis allows considering neurogenic pulmonary edema to be one of the forms of acute respiratory distress syndrome. It has diagnostic criteria common with acute respiratory distress syndrome, which are identified during acute cerebral injury and not associated with the other etiological factors. Currently, there are no effective prevention and treatment of neurogenic pulmonary edema. Support of respiratory exchange through artificial pulmonary ventilation is a major tool used for its management, which is recommended to be performed in compliance with protective ventilation principles. And some particular approaches of the preventive ventilation can be applied only with neuromonitoring.
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