Khan Muhammad Faisal, Azfar Mohammad Feroz, Khurshid Syed Moazzum
Department of Critical Care, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Indian J Crit Care Med. 2014 Jun;18(6):392-5. doi: 10.4103/0972-5229.133931.
Patients with traumatic brain injury complicated by acute respiratory distress syndrome (ARDS) are not uncommon in intensive care unit (ICU). The ventilatory management of patients combined with both of these catastrophic conditions is not straightforward. Evidence-based permissive hypercapnia strategy for ARDS could be fatal in patients with intracranial hypertension. Adjunctive use of inhaled nitric oxide (INO) is well-defined as a rescue therapy in severe ARDS, but its specific role in intracranial hypertension is somewhat uncertain. We report a case, which following traumatic brain injury developed both intracranial hypertension and ARDS. INO was given for ARDS, but coincidentally it also improved the raised intracranial pressure (ICP) and patient's neurological outcome. The case report will be followed by literature review on the role of INO in raised ICP.
创伤性脑损伤并发急性呼吸窘迫综合征（ARDS）的患者在重症监护病房（ICU）并不少见。同时患有这两种严重疾病的患者的通气管理并非易事。基于证据的ARDS允许性高碳酸血症策略在颅内高压患者中可能是致命的。吸入一氧化氮（INO）辅助治疗在重度ARDS中被明确为一种挽救疗法，但其在颅内高压中的具体作用尚不确定。我们报告一例病例，该患者在创伤性脑损伤后出现颅内高压和ARDS。给予INO治疗ARDS，但巧合的是它也改善了升高的颅内压（ICP）和患者的神经功能结局。病例报告之后将进行关于INO在升高的ICP中的作用的文献综述。
