Publication: High-frequency oscillatory ventilation with tracheal gas insufflation: The rescue strategy for brain-lung interaction
Issued Date
2013-08-27
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ISSN
1466609X
13648535
13648535
DOI
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2-s2.0-84887565705
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Mahidol University
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SCOPUS
Bibliographic Citation
Critical Care. Vol.17, No.4 (2013)
Suggested Citation
Paolo Pelosi, Yuda Sutherasan High-frequency oscillatory ventilation with tracheal gas insufflation: The rescue strategy for brain-lung interaction. Critical Care. Vol.17, No.4 (2013). doi:10.1186/cc12862 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/32204
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Title
High-frequency oscillatory ventilation with tracheal gas insufflation: The rescue strategy for brain-lung interaction
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Abstract
The occurrence of moderate to severe acute respiratory distress syndrome due to traumatic brain injury is not uncommon and is associated with an extremely high incidence of morbidity and mortality. Owing to the complex interaction between the lung and brain, protective ventilation for the lung with lower tidal volume and higher positive end-expiratory pressure with or without mild hypercapnia might be harmful for the brain, and maintaining normocapnia or mild hypocapnia by increasing tidal volume or respiratory rate (or both) with lower positive end-expiratory pressure levels for protecting the brain might lead to ventilator-induced lung injury. Balancing the end-point between lungs and brain becomes a challenging issue, and non-conventional modes of mechanical ventilation might play a role in the more difficult clinical cases. In this commentary, the authors discuss the rationale, based on the physiologic principle of targeting both vital organs, of applying high-frequency oscillation and tracheal gas insufflation in acute respiratory distress syndrome patients with traumatic brain injury. © 2013 Pelosi and Sutherasan; licensee BioMed Central Ltd.