====== Positive end-expiratory pressure ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/12QQbiNmM99hURBLDKM5CZYzZXjfhbTASM_SEt-oqGDvzJnE3t/?limit=15&utm_campaign=pubmed-2&fc=20241213181816}}
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Patients with [[brain]] [[damage]] often require [[mechanical ventilation]]. Although lung-protective ventilation is recommended, the application of increased positive end-expiratory pressure (PEEP) has been associated with elevated [[intracranial pressure]] (ICP) due to altered cerebral venous return. 
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[[Neurocritical care]] (NCC) is not only generally guided by principles of general [[intensive care]] but also directed by specific goals and methods. 
A review by Wen et al. summarizes the common [[pulmonary diseases]] and [[pathophysiology]] affecting NCC patients and the progress made in strategies of respiratory support in NCC. This review highlights the possible interactions and [[pathway]]s that have been revealed between neurological injuries and respiratory diseases, including the [[catecholamine]] pathway, systemic [[inflammatory]] reactions, [[adrenergic hypersensitivity]], and dopaminergic signaling. Pulmonary complications of neurocritical patients include [[pneumonia]], neurological [[pulmonary edema]], and [[respiratory distress]]. Specific aspects of respiratory management include prioritizing the [[brain protection]], and the goal of respiratory management is to avoid inappropriate blood gas composition levels and [[intracranial hypertension]]. Compared with the traditional mode of protective [[mechanical ventilation]] with low [[tidal volume]] (Vt), high positive end-expiratory pressure ([[PEEP]]), and recruitment maneuvers, low PEEP might yield a potential benefit in closing and protecting the lung [[tissue]]. [[Multimodal neuromonitoring]] can ensure the safety of respiratory maneuvers in clinical and scientific practice. Future studies are required to develop guidelines for respiratory management in NCC
((Wen J, Chen J, Chang J, Wei J. [[Pulmonary complications]] and respiratory management in [[neurocritical care]]: a narrative review. Chin Med J (Engl). 2022 Apr 5;135(7):779-789. doi: 10.1097/CM9.0000000000001930. PMID: 35671179.)).