JOURNAL ARTICLE
REVIEW

Crosstalk between brain, lung and heart in critical care

Ségolène Mrozek, Julie Gobin, Jean-Michel Constantin, Olivier Fourcade, Thomas Geeraerts
Anaesthesia, Critical Care & Pain Medicine 2020 July 10
32659457
Extracerebral complications, especially pulmonary and cardiovascular, are frequent in brain-injured patients and are major determinants of the outcome. 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 œdema (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.

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