Respiratory emergencies in neurological diseases

Abstract

Many neurological diseases can cause acute respiratory failure due to impairment of bulbar respiratory control centres, cervical or thoracic spinal cord, motor neurons, peripheral nerves, neuromuscular junction, or skeletal muscles. Hypoxemia and/or hypercapnia can be a complication of cerebrovascular diseases, brain tumours, head or spinal trauma, and infectious, inflammatory, or degenerative diseases of the central nervous system, by their direct effect or the onset of complications such as bronchopneumonia, pulmonary oedema, or traumatic pneumothorax. Respiratory failure can often also occur in patients with acute or chronic neuromuscular diseases, because of weakness of the diaphragm and intercostal muscles, or concomitant respiratory complications, due to oropharyngeal dysfunction. This review provides recommendations to prevent, diagnose and manage respiratory emergencies in neurological patients.