2022, Number 1
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Revista Cubana de Anestesiología y Reanimación 2022; 21 (1)
Recommendations for invasive ventilatory management witch ischemic stroke and COVID-19
Sosa RA, Cuba NAJ, Jerez ÁAE
Language: Spanish
References: 36
Page:
PDF size: 671.67 Kb.
ABSTRACT
Introduction: The main guidelines for the treatment of ischemic stroke in the
course of COVID-19 infection do not offer suggestions on the use of artificial
mechanical ventilation in these patients.
Objective: Describe elements of interest on the use of artificial mechanical
ventilation in patients with ischemic stroke and COVID-19.
Method: Narrative review of the literature available in English and Spanish in
databases such as: PubMed, SciELO and Google scholar. The descriptors “COVID-
19”, “SARS-CoV-2”, “neurological manifestations”, “acute ischemic stroke”,
“acute brain injury”, “mechanical ventilation”, “respiratory failure”, “ARDS”,
“neurocritical care”, among others, were used. Given the scarce published
evidence, the criteria presented were carried out on the basis of what was
reported for patients with ischemic stroke and mechanical ventilation without
COVID-19.
Results: Ischemic stroke in the course of COVID-19 infection has a high mortality
rate. It occurs mainly in the most severe stage of the disease, mostly in patients
with acute respiratory distress syndrome. The use of mechanical ventilation can
be controversial because of its effect on the brain.
Conclusions: To date there are no publications on ventilatory management in this
particular case. Based on what has been documented in ventilated patients with
ischemic stroke or acute brain damage, protective ventilation can be used safely,
as well as the use of prone position maneuvers, always under strict monitoring of
intracranial pressure.
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