4.3 Review

Crosstalk between brain, lung and heart in critical care

Journal

ANAESTHESIA CRITICAL CARE & PAIN MEDICINE
Volume 39, Issue 4, Pages 519-530

Publisher

ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
DOI: 10.1016/j.accpm.2020.06.016

Keywords

Acute respiratory distress syndrome; Brain injury; Brain-lung crosstalk; Brain-heart crosstalk; Cardiomyopathy; Neurogenic pulmonary cedema

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Extracerebral complications, especially pulmonary and cardiovascular, are frequent in brain-injured patients and are major outcome determinants. Two major pathways have been described: brain-lung and brain-heart interactions. Lung injuries after acute brain damages include ventilator-associated pneumonia (VAP), acute respiratory distress syndrome (ARDS) and neurogenic pulmonary oedema (NPE), whereas heart injuries can range from cardiac enzymes release, ECG abnormalities to left ventricle dysfunction or cardiogenic shock. The pathophysiologies of these brain-lung and brain-heart crosstalk are complex and sometimes interconnected. This review aims to describe the epidemiology and pathophysiology of lung and heart injuries in brain-injured patients with the different pathways implicated and the clinical implications for critical care physicians. (C) 2020 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

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