Author: Kim, Jennifer A.; Wahlster, Sarah; LaBuzetta, Jamie Nicole; Nobleza, Christa O’Hana S.; Johnson, Nicholas J.; Rubinos, Clio; Malaiyandi, Deepa; O’Phalen, Kristine H.; Mainali, Shraddha; Sarwal, Aarti; Gilmore, Emily J.
Title: Focused Management of Patients with Severe Acute Brain Injury and ARDS Cord-id: 4tjxjcwj Document date: 2021_9_8
ID: 4tjxjcwj
Snippet: Considering the COVID-19 pandemic where concomitant occurrence of acute respiratory distress syndrome (ARDS) and severe acute brain injury (sABI) has increasingly co-emerged, we synthesize existing data regarding the simultaneous management of both conditions. Our aim is to provide readers with fundamental principles and concepts for the management of sABI and ARDS, and highlight challenges and conflicts encountered while managing concurrent disease. Up to 40 percent of patients with sABI can de
Document: Considering the COVID-19 pandemic where concomitant occurrence of acute respiratory distress syndrome (ARDS) and severe acute brain injury (sABI) has increasingly co-emerged, we synthesize existing data regarding the simultaneous management of both conditions. Our aim is to provide readers with fundamental principles and concepts for the management of sABI and ARDS, and highlight challenges and conflicts encountered while managing concurrent disease. Up to 40 percent of patients with sABI can develop ARDS. While there are trials and guidelines to support the mainstays of treatment for ARDS and sABI independently, guidance on concomitant management is limited. Treatment strategies aimed at managing severe ARDS may at times conflict with the management of sABI. In this narrative review, we discuss the physiological basis and risks involved during simultaneous management of ARDS and sABI, summarize evidence for treatment decisions, and demonstrate these principles using hypothetical case scenarios. Use of invasive or non-invasive monitoring to assess brain and lung physiology may facilitate goal-directed treatment strategies with the potential to improve outcome. Understanding the pathophysiology and key treatment concepts for co-management of these conditions is critical to optimizing care in this high-acuity patient population.
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