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Mechanical ventilation (ischemic stroke) in sickle cell disease

Mechanical ventilation is a form of management of ischemic stroke in sickle cell disease patients. Mechanical ventilation is often performed in these patients due to a seen swallowing disorder and an airway or a respiratory system compromise. 

Sickle cell disease patients with stroke-induced immunosuppression and brain organ crosstalk have an increased rate of pulmonary damage and pulmonary inflammation, and also a reduced alveolar phagocytic capability increases the risk of infection. Severely brain-damaged sickle cell disease patients are commonly unable to protect their airway and therefore are often admitted to the neurological intensive care unit NICU for mechanical ventilation. However, prolonged mechanical ventilation is then associated with an increased risk of developing ventilator-associated lung injury, acute respiratory distress syndrome ARDS, pneumonia, and neurogenic pulmonary edema. 

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Photo Credit: Chest Journal

Pulmonary complications such as respiratory failure, pneumonia, pleural effusions, acute respiratory distress syndrome ARDS, lung edema, and pulmonary embolism from venous thromboembolism is some of the major cause of death in sickle cell disease patients, hence the need for mechanical ventilation. 

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Photo Credit: SpringerLink

Ischemic stroke is one of the leading causes of morbidity and mortality rate in sickle cell disease patients and about eighty percent (80%) of sickle cell disease strokes are ischemic in cause and nature. The major types of ischemic stroke found in sickle cell disease patients are; intracerebral ICH, hemorrhage, intraventricular IVH hemorrhage, cerebral venous thrombosis, sinus thrombosis, and subarachnoid hemorrhage SAH secondary to aneurysm leak or rupture. 

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Photo Credit: The Lancet

The location of the stroke is a prominent factor that relates to the need for mechanical ventilation in sickle cell disease patients, rather than the particular type of cerebrovascular pathology. Due to the high incidence of respiratory complications in sickle cell disease patients with stroke, optimal ventilator management is mandatory. 

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Photo Credit: Semantic Scholar

The essence of mechanical ventilation is to obtain and maintain appropriate oxygen levels and tight control of carbon dioxide tension without inducing a ventilator-associated lung damage to patients. 

Content created and supplied by: Dr-Kikiope (via Opera News )

Chest Journal


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