May sevoflurane prevent the development of neurogenic pulmonary edema and improve the outcome? Or as a new sedation method for severe brain injury patients

Yang, Aobing; Liu, Bin

doi:10.1016/j.mehy.2019.109538

Cited by 4 publications

(3 citation statements)

References 74 publications

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“…With many being unfamiliar with handling this condition, this has proven to be a chaotic and difficult complication to handle. 32, 84 Current treatments for NPE are aimed to reduce intracranial pressure and control sympathetic hyperactivity related to lung injury. Sympathetic hyperactivity has been a promising target of multiple innovative NPE treatments.…”

Section: Neurogenic Pulmonary Edemamentioning

confidence: 99%

“…Prior studies have additionally demonstrated sevoflurane's antioxidant, metabolic, and hemodynamic benefits, and it is hypothesized to have the clinical utility in improving neurological and pulmonary functional outcomes in NPE. 32, 84 Likewise, atropine has received attention for similar sympatholytic properties. A hypothesis has been introduced that high doses of atropine could prevent NPE by attenuating the baroreflexive bradycardic response to increased systemic blood pressure.…”

Section: Neurogenic Pulmonary Edemamentioning

confidence: 99%

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Respiratory Patterns in Neurological Injury, Pathophysiology, Ventilation Management, and Future Innovations: A Systematic Review

Goldman¹,

Lucke‐Wold²,

Katz³

et al. 2022

Explor Res Hypothesis Med

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Traumatic brain injuries (TBI), ischemic stroke, hemorrhagic stroke, brain tumors, and seizures have diverse and sometimes overlapping associated breathing patterns. Homeostatic mechanisms for respiratory control are intertwined with complex neurocircuitry, both centrally and peripherally. This paper summarizes the neurorespiratory control and pathophysiology of its disruption. It also reviews the clinical presentation, ventilatory management, and emerging therapeutics. This review additionally serves to update all recent preclinical and clinical research regarding the spectrum of respiratory dysfunction. Having a solid pathophysiological foundation of disruptive mechanisms would permit further therapeutic development. This novel review bridges experimental/physiological data with bedside management, thus allowing neurosurgeons and intensivists alike to rapidly diagnose and treat respiratory sequelae of acute brain injury.

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Section: Neurogenic Pulmonary Edemamentioning

confidence: 99%

Section: Neurogenic Pulmonary Edemamentioning

confidence: 99%

Respiratory Patterns in Neurological Injury, Pathophysiology, Ventilation Management, and Future Innovations: A Systematic Review

Goldman¹,

Lucke‐Wold²,

Katz³

et al. 2022

Explor Res Hypothesis Med

View full text Add to dashboard Cite

show abstract

“…Regarding the prevention of NPE, it has been postulated that the administration of sevoflurane [ 51 ], caspase-1 inhibitor [ 52 ], and atropine [ 53 ] have the ability to prevent this complication. However, studies are insufficient and some have been performed only in non-human models [ 52 ].…”

Section: Main Textmentioning

confidence: 99%

Neurogenic pulmonary edema in subarachnoid hemorrhage: relevant clinical concepts

et al. 2021

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Background Subarachnoid hemorrhage (SAH) continues to be a condition that carries high rates of morbidity, mortality, and disability around the world. One of its complications is neurogenic pulmonary edema (NPE), which is mainly caused by sympathetic hyperactivity. Due to the complexity of the pathophysiological process and the unspecificity of the clinical presentation, it is little known by general practitioners, medical students and other health care workers not directly related to the neurological part, making the management of this chaotic condition difficult. This review aims to present recent evidence on clinical concepts relevant to the identification and management of NPE secondary to SAH. Main body of the abstract NPE is defined as a syndrome of acute onset following significant central nervous system (CNS) injury. Its etiology has been proposed to stem from the release of catecholamines that produce cardiopulmonary dysfunction, with this syndrome being associated with spinal cord injury, cerebrovascular disorders, traumatic brain injury, status epilepticus, and meningitis. NPE has long been considered a rare event; but it may occur more frequently, mainly in patients with SAH. There are two clinical presentations of NPE: the early form develops in the first hours/minutes after injury, while the late form presents 12–24 h after neurological injury. Clinical manifestations consist of non-specific signs of respiratory distress: dyspnea, tachypnea, hypoxia, pink expectoration, crackles on auscultation, which usually resolve within 24–48 h in 50% of patients. Unfortunately, there are no tools to make the specific diagnosis, so the diagnosis is by exclusion. The therapeutic approach consists of two interventions: treatment of the underlying neurological injury to reduce intracranial pressure and control sympathetic hyperactivity related to the lung injury, and supportive treatment for pulmonary edema. Short conclusion SAH is a severe condition that represents a risk to the life of the affected patient due to the possible complications that may develop. NPE is one of these complications, which due to the common manifestation of a respiratory syndrome, does not allow early and accurate diagnosis, being a diagnosis of exclusion. Therefore, in any case of CNS lesion with pulmonary involvement, NPE should be suspected immediately.

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A competing risk model analysis of dexmedetomidine of in-hospital mortality in subarachnoid hemorrhage patients

Wang,

Lin

2024

Sci Rep

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May sevoflurane prevent the development of neurogenic pulmonary edema and improve the outcome? Or as a new sedation method for severe brain injury patients

Cited by 4 publications

References 74 publications

Respiratory Patterns in Neurological Injury, Pathophysiology, Ventilation Management, and Future Innovations: A Systematic Review

Respiratory Patterns in Neurological Injury, Pathophysiology, Ventilation Management, and Future Innovations: A Systematic Review

Neurogenic pulmonary edema in subarachnoid hemorrhage: relevant clinical concepts

A competing risk model analysis of dexmedetomidine of in-hospital mortality in subarachnoid hemorrhage patients

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