Characterization of molecular forms of N-terminal B-type natriuretic peptide in vitro. Instead, the APACHE II score, expressing the severity of disease on admission considering different physiologic variables, was an independent risk factor for NPE, which is an original finding. Neurogenic pulmonary edema. Jennett B, Bond M. Assessment of outcome after severe brain damage. Acute lung injury in patients with subarachnoid hemorrhage: incidence, risk factors, and outcome. Stroke. Negative pressure pulmonary edema (NPPE) is an uncommon complication of anesthesia usually resulting from laryngospasm during extubation (approximately 0.1%). 1985;13:818–29, 22. Deehan SC, Grant IS. 1Markedly negative intrapleural pressures during airway occlusion cause increased venous return and increased left ventricular afterload. Registered users can save articles, searches, and manage email alerts. One explanation could be that NPE occurred more frequently in more severely ill patients (defined by APACHE II) with worse outcome.47 This finding supports the claim that the aggressive supportive therapy for cardiovascular complications in the ICU may eliminate the negative impact of these complications on the outcome.48 It is notable, however, that such aggressive therapy, particularly excessive fluid resuscitation, may result in pulmonary edema and even worsen the outcome.49. NPE is a potential contributor to the pulmonary dysfunction that occurs in these patients. Goals . Craniotomy was performed in 42 patients (39%) before the first study blood samples and in 51 (47%) during the entire study period. Lehto SM, Niskanen L, Herzig KH, Tolmunen T, Huotari A, Viinamäki H, Koivumaa-Honkanen H, Honkalampi K, Ruotsalainen H, Hintikka J. Serum chemokine levels in major depressive disorder. Neurology. The 1-year outcome was assessed using the Glasgow Outcome Scale. 2011;15:211–40, 25. It is notable, however, that it is presumed that pneumonia causes the increasing of CRP and PCT values, and according to our study results, there were no differences in CRP and PCT values between the patients with and without NPE (Table 2). You may be trying to access this site from a secured browser on the server. Wartenberg KE, Schmidt JM, Claassen J, Temes RE, Frontera JA, Ostapkovich N, Parra A, Connolly ES, Mayer SA. Neurogenic pulmonary oedema was first reported in association with status epilepticus in 1908 and with head injury in 1918. Hemodynamic control & monitoring: Minimize transmural pressure to avoid rebleed . Anesthesia & Analgesia116(4):855-861, April 2013. Please enable scripts and reload this page. Intensive Care Med. Lancet. Crit Care Med. This occurrence has been termed neurogenic pulmonary edema (NPE), and experimental ... A variety of central nervous system (CNS) insults may be complicated by the acute development of … 1994;44:815–20, 9. Finally, the other medical conditions, such as pneumonia and surgical interventions, may have confounded the diagnosis of NPE and the levels of the inflammatory mediators. 1975;2:749–51, 11. ICU = intensive care unit; AVM = arteriovenous malformation. Pulmonary and cardiac sequelae of subarachnoid haemorrhage: time for active management? Cardiac injury associated with neurogenic pulmonary edema following subarachnoid hemorrhage. Summary Two young patients with head injuries subsequently developed neurogenic pulmonary oedema. During the ICU stay, all patients were treated according to our normal clinical practice, consistent with the latest guidelines.22–24 The data regarding neurosurgical and endovascular interventions were retrieved from daily medical reports. 2009;40:994–1025, 23. 2006;32:1547–52, 28. Clinical characteristics, level of consciousness, and Acute Physiology and Chronic Health Evaluation (APACHE) II score were recorded on admission and the findings of primary head computed tomography were reviewed. There have been 2 previous study reports written based on these data.19,20. 1984;140:490–4, 34. In this study, we demonstrated that the systemic IL-6 concentration was an independent predictor for NPE. The main findings of this study are that (1) the independent predictors for NPE were the severity of disease defined by APACHE II score and higher IL-6 levels; and (2) NPE was associated with a higher 1-year mortality, but not with a poorer 1-year functional outcome. 2008;29:2388–442, 29. Hypothyroid. Contribution: This author helped design the study, conduct the study, analyze the data, and write the manuscript. With and without NPE injury in patients with intensive care unit APACHE II: a of... 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