Skip to main content

Respiratory Management in Neurological Intensive Care

  • Chapter
  • First Online:
Neurocritical Care
  • 1110 Accesses

Abstract

Artificial ventilation is the most important management in the intensive care and neurological intensive care units. Respiratory management (including airway management) is the top priority particulars of the intensive care ABCD protocol and must be universally executed regardless of disease. It is important to maintain proper oxygenation and ventilation to prevent excessive breathing work. In particular, regarding ventilation (CO2) management, it is important not to normalize PaCO2 level but to aim for optimization of blood pH. When intracranial pressure is increased, appropriate management of ventilation is given top priority, and in cases of emergency, hyperventilation management is performed as a temporary measure. It is important that artificial ventilatory management is to ensure short duration of the procedure. To achieve the same, standard, weaning methods such as daily interruption of sedatives (DIS) and spontaneous breathing trial (SBT) should be followed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Stocchetti N, Taccone FS, Citerio G, et al. Neuroprotection in acute brain injury: an up-to-date review. Crit Care. 2015;19:186.

    Article  Google Scholar 

  2. Society of Critical Care Medicine. Mechanical ventilation. In: Killu K, Sarani B, editors. Fundamental critical care support. 6th ed; 2017. p. 59–89.

    Google Scholar 

  3. Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301–8.

    Article  Google Scholar 

  4. Malhotra A. Low-tidal-volume ventilation in the acute respiratory distress syndrome. N Engl J Med. 2007;357:1113–20.

    Article  CAS  Google Scholar 

  5. Kress JP, Pohlman AS, O’Connor MF, et al. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med. 2000;342:1471–7.

    Article  CAS  Google Scholar 

  6. Girard TD, Kress JP, Fuchs BD, et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanical ventilated patients in intensive care (awakening and breathing controlled trial): a randomized controlled trial. Lancet. 2008;371:126–34.

    Article  Google Scholar 

  7. Esteban A, Frutos F, Tobin MJ, et al. A comparison of four methods of weaning patients from mechanical ventilation. Spanish Lung failure Collaborative Group. N Engl J Med. 1995;332:345–50.

    Article  CAS  Google Scholar 

  8. Barr J, Fraser GL, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41:263–306.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rikimaru Kogawa .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kogawa, R. (2019). Respiratory Management in Neurological Intensive Care. In: Kinoshita, K. (eds) Neurocritical Care . Springer, Singapore. https://doi.org/10.1007/978-981-13-7272-8_2

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-7272-8_2

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-7271-1

  • Online ISBN: 978-981-13-7272-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics