Balofsky A, George J, Papadakos P
Department of Anesthesiology, University of Rochester Medical Center, Rochester, NY, USA.
Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.
Handb Clin Neurol. 2017;140:33-48. doi: 10.1016/B978-0-444-63600-3.00003-9.
Neuropulmonology refers to the complex interconnection between the central nervous system and the respiratory system. Neurologic injury includes traumatic brain injury, hemorrhage, stroke, and seizures, and in each there are far-reaching effects that can result in pulmonary dysfunction. Systemic changes can induce impairment of pulmonary function due to changes in the core structure and function of the lung. The conditions and disorders that often occur in these patients include aspiration pneumonia, neurogenic pulmonary edema, and acute respiratory distress syndrome, but also several abnormal respiratory patterns and sleep-disordered breathing. Lung infections, pulmonary edema - neurogenic or cardiogenic - and pulmonary embolus all are a serious barrier to recovery and can have significant effects on outcomes such as hospital course, prognosis, and mortality. This review presents the spectrum of pulmonary abnormalities seen in neurocritical care.
神经肺病学指的是中枢神经系统与呼吸系统之间的复杂相互联系。神经损伤包括创伤性脑损伤、出血、中风和癫痫发作，每一种损伤都会产生深远影响，进而导致肺功能障碍。全身变化可因肺核心结构和功能的改变而引起肺功能损害。这些患者中经常出现的病症包括吸入性肺炎、神经源性肺水肿和急性呼吸窘迫综合征，还有几种异常呼吸模式和睡眠呼吸障碍。肺部感染、神经源性或心源性肺水肿以及肺栓塞都是康复的严重障碍，并且会对诸如住院病程、预后和死亡率等结果产生重大影响。本综述介绍了神经重症监护中出现的一系列肺部异常情况。
