[Lung-brain interaction in the mechanically ventilated patient]

Abstract

Patients with acute lung injury or acute respiratory distress syndrome (ARDS) admitted to the ICU present neuropsychological alterations, which in most cases extend beyond the acute phase and have an important adverse effect upon quality of life. The aim of this review is to deepen in the analysis of the complex interaction between lung and brain in critically ill patients subjected to mechanical ventilation. This update first describes the neuropsychological alterations occurring both during the acute phase of ICU stay and at discharge, followed by an analysis of lung-brain interactions during mechanical ventilation, and finally explores the etiology and mechanisms leading to the neurological disorders observed in these patients. The management of critical patients requires an integral approach focused on minimizing the deleterious effects over the short, middle or long term.

Keywords: Acute lung injury; Acute respiratory distress syndrome; Alteraciones neuropsicológicas y cognitivas; Central nervous system; Confusional syndrome; Delirio; Delirium; Intensive care unit; Interacción pulmón-cerebro; Lesión pulmonar aguda; Lung-brain interaction; Mechanical ventilation; Neuropsychological and cognitive impairment; Sistema nervioso central; Síndrome confusional; Síndrome de distrés respiratorio agudo; Unidad de cuidados intensivos; Ventilación mecánica.