title: Respiratory mechanics in brain injury: A review.
abstract: Several clinical and experimental studies have shown that lung injury occurs shortly after brain damage. The responsible mechanisms involve neurogenic pulmonary edema, inflammation, the harmful action of neurotransmitters, or autonomic system dysfunction. Mechanical ventilation, an essential component of life support in brain-damaged patients (BD), may be an additional traumatic factor to the already injured or susceptible to injury lungs of these patients thus worsening lung injury, in case that non lung protective ventilator settings are applied. Measurement of respiratory mechanics in BD patients, as well as assessment of their evolution during mechanical ventilation, may lead to preclinical lung injury detection early enough, allowing thus the selection of the appropriate ventilator settings to avoid ventilator-induced lung injury. The aim of this review is to explore the mechanical properties of the respiratory system in BD patients along with the underlying mechanisms, and to translate the evidence of animal and clinical studies into therapeutic implications regarding the mechanical ventilation of these critically ill patients.
authors: Antonia Koutsoukou, Maria Daganou, Magdalini Kyriakopoulou, Nikoletta Rovina, ICU, First Department of Respiratory Medicine, University of Athens Medical School, Sotiria Hospital, 11527 Athens, Greece.
authors: Antonia
authors: A
authors: Koutsoukou
authors: Antonia Koutsoukou, Maria Daganou, Magdalini Kyriakopoulou, Nikoletta Rovina, ICU, First Department of Respiratory Medicine, University of Athens Medical School, Sotiria Hospital, 11527 Athens, Greece.
authors: Maria
authors: M
authors: Katsiari
authors: Antonia Koutsoukou, Maria Daganou, Magdalini Kyriakopoulou, Nikoletta Rovina, ICU, First Department of Respiratory Medicine, University of Athens Medical School, Sotiria Hospital, 11527 Athens, Greece.
authors: Stylianos E
authors: SE
authors: Orfanos
authors: Antonia Koutsoukou, Maria Daganou, Magdalini Kyriakopoulou, Nikoletta Rovina, ICU, First Department of Respiratory Medicine, University of Athens Medical School, Sotiria Hospital, 11527 Athens, Greece.
authors: Anastasia
authors: A
authors: Kotanidou
authors: Antonia Koutsoukou, Maria Daganou, Magdalini Kyriakopoulou, Nikoletta Rovina, ICU, First Department of Respiratory Medicine, University of Athens Medical School, Sotiria Hospital, 11527 Athens, Greece.
authors: Maria
authors: M
authors: Daganou
authors: Antonia Koutsoukou, Maria Daganou, Magdalini Kyriakopoulou, Nikoletta Rovina, ICU, First Department of Respiratory Medicine, University of Athens Medical School, Sotiria Hospital, 11527 Athens, Greece.
authors: Magdalini
authors: M
authors: Kyriakopoulou
authors: Antonia Koutsoukou, Maria Daganou, Magdalini Kyriakopoulou, Nikoletta Rovina, ICU, First Department of Respiratory Medicine, University of Athens Medical School, Sotiria Hospital, 11527 Athens, Greece.
authors: Nikolaos G
authors: NG
authors: Koulouris
authors: Antonia Koutsoukou, Maria Daganou, Magdalini Kyriakopoulou, Nikoletta Rovina, ICU, First Department of Respiratory Medicine, University of Athens Medical School, Sotiria Hospital, 11527 Athens, Greece.
authors: Nikoletta
authors: N
authors: Rovina
keywords: Brain damage; Lung injury; Positive end-expiratory pressure; Respiratory mechanics; Ventilator-induced lung injury