CC BY-NC-ND 4.0 · Journal of Neuroanaesthesiology and Critical Care 2017; 04(04): S45-S48
DOI: 10.4103/2348-0548.199948
Conference Proceeding
Thieme Medical and Scientific Publishers Private Ltd.

Lung maladies following aneurysmal subarachnoid haemorrhage

Gentle S. Shrestha
1  Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
› Author Affiliations
Further Information

Publication History

Publication Date:
08 May 2018 (online)

  

Abstract

Pulmonary complications are common in patients with aneurysmal subarachnoid haemorrhage. It is associated with adverse outcome in the form of higher incidence of vasospasm, poor neurological outcome, longer length of stay and higher mortality. These patients are at high risk for ventilator associated pneumonia. Preventive measures, early detection and timely appropriate treatment is important. Acute respiratory distress is common in patients with subarachnoid haemorrhage. Measures to minimize the second hit to the vulnerable lungs is crucial. Low tidal volume ventilation, application of PEEP and prone ventilation should be used with special emphasis to avoid hypercarbia and increase in intracranial pressure. Activation of sympathetic nervous system, release of catecholamine and damage to pulmonary endothelium can lead to neurogenic pulmonary edema. Treatment of underlying cause and supportive care is helpful. These patients are at high risk of deep vein thrombosis and pulmonary embolism. Measures to prevent deep vein thrombosis and administration of pharmacological prophylaxis when safe, needs to be considered.