Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 10 , ISSUE 3 ( September-December, 2021 ) > List of Articles


Brain–Lung Interaction in Neurotrauma in COVID-19 Patients

William AF Perdomo

Keywords : Lung, Neurocritical care, Neurotrauma

Citation Information : Perdomo WA. Brain–Lung Interaction in Neurotrauma in COVID-19 Patients. Panam J Trauma Crit Care Emerg Surg 2021; 10 (3):139-140.

DOI: 10.5005/jp-journals-10030-1353

License: CC BY-NC 4.0

Published Online: 18-01-2022

Copyright Statement:  Copyright © 2021; The Author(s).


The recently described coronavirus (SARS-CoV-2) has produced a series of pathological changes after infection of the human body. A significant percentage of infected critically ill patients with COVID-19 will require multiple intensive care strategies to give appropriate support to increase the possibility of favorable evolution. The new coronavirus could invade using the respiratory mucosa and to infect various cell types successively creating a severe inflammatory response. Patients with cerebral neurotrauma have elements associated with the primary and secondary lesions. Lung injury impact brain with hypoxia, hypercapnia, hypocapnia, mediators release, presence of neurotoxic factors, and endothelial activation. On the other hand, brain injury impacts lungs due to increase in intracranial pressure (ICP). There is development of neuroinflammatory phenomena, the activation of sympathetic nervous system, and the presence of intense dopaminergic activity through the hypothalamic-pituitary-adrenal axis. Studies have demonstrated injury at the ultrastructural level in type II pneumocytes after traumatic brain injury.

  1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727–733. DOI: 10.1056/NEJMoa2001017
  2. Janjua T, Nussbaum E, Lowary J, et al. Bivalirudin as a bridge for anticoagulation in high risk neurosurgical patients with active DVT or high risk of thrombosis. Neurocrit Care 2013;18(3):349–353. DOI: 10.1007/s12028-013-9835-0
  3. Shereen MA, Khan S, Kazmi A, et al. COVID-19 infection: origin, transmission, and characteristics of human coronaviruses J Adv Res 2020;24:91–98. DOI: 10.1016/j.jare.2020.03.005
  4. Guo YR, Cao QD, Hong ZS, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res 2020;7(1):11. DOI:10.1186/s40779-020-00240-0
  5. Stocker RA. Intensive care in traumatic brain injury including multi-modal monitoring and neuroprotection. Med Sci (Basel) 2019;7(3):37. DOI:10.3390/medsci7030037
  6. Yildirim E, Kaptanoglu E, Ozisik K, et al. Ultrastructural changes in pneumocyte type II cells following traumatic brain injury in rats. Eur J Cardiothorac Surg 2004;25(4):523–529. DOI:10.1016/j.ejcts.2003.12.021
  7. Chen X, Song Y, Liu Z, et al. Ultrastructural lung pathology following brain injury combined with femur shaft fracture in a rat model. J Trauma Acute Care Surg 2015;78(3):558–564. DOI:10.1097/TA.0000000000000538
  8. Blanch Ll. “Brain-Lung Interactions in the critically Ill.” Retrieved from:
  9. Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA 2020;323(16):1574–1581. DOI:10.1001/jama.2020.539
  10. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223): 497–506. DOI: 10.1016/S0140-6736(20)30183-5
  11. Sun P, Qie S, Liu Z, et al. Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: a single arm meta-analysis. J Med Virol 2020;92(6):612–617. DOI:10.1002/jmv.25735
  12. Abdussalam AL. Severe respiratory failure and traumatic brain injuries: what do we know? Qatar Med J 2017;2017(1):40. DOI: 10.5339/qmj.2017.swacelso.40
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