Brain-lung crosstalk: Implications for neurocritical care patients

Table 1 Effects of protective ventilation on brain hemodynamic and metabolism

	CBF	ICP	CPP	PtiO2	SjO2	Lactates (microdialysis)
High Vt In pigs with ARDS[117]				↓		↑
Low Vt In pigs with ARDS[117]				↑		↓
Permissive hypercapnia (PaCO2: 40-60 mmHg) in patients with SAH[132,133]	↑	=	=	↑
PEEP	= if MAP is maintained[140]	= if responder patient[137]	= if responder patient[137]
		↑ If non-responder patient[137]	↓ If non-responder patient[137]
RM		↑ If MAP decreased[148]	↓ If MAP decreased[148]		↓ If MAP decreased[148]
Open lung approach (low Vt + high PEEP + RM) in patients with acute brain injury and ARDS[155]		=	=	=

Responder patient to PEEP: Decrease in elastance and increased PaO₂; Non-responder patient to PEEP: Increase in elastance and PaCO₂. CBF: Cerebral blood flow; ICP: Intracranial pressure; CPP: Cerebral perfusion pressure; P_tiO₂: Cerebral tissue oxygenation; SjO₂: Jugular vein oxygen saturation; Vt: Tidal volume; PEEP: Positive end-expiratory pressure; RM: Recruitment maneuvers; MAP: Mean arterial pressure; ARDS: Acute respiratory distress syndrome.