engleski

Mechanical ventilation with high positive endexpiratory pressure in patient with acute subarachnoid haemorrhage, elevated intracranial pressure and acute respiratory distress syndrome: a case report

Acute respiratory distress syndrome is an acute diffuse, inflammatory lung injury, leading to hypoxaemia. Severe ARDS is defined with PaO2/FiO2 ratio<100.Protective lung ventilation, recruitment maneuvers and permissive hypercapnia are the treatment and respiratory management in ARDS patients. Such treatment could be challenging in patient with subarachnoid haemorrhage caused by ruptured cerebral aneurysm and elevated intracranial pressure. Complex pathophysiology of disfunction of two organs and protective therapy raises the question/dilemma: “to save the lungs or to save the brain”? Recruitment maneuvers in patients with SAH hypothesize ICP increase. We decided to perform gradual recruitment maneuver because better lung function improves blood oxygenation with a greater oxygen delivery to brain.

SAH, mechanical ventilation, PEEP

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