Severe Respiratory Failure: ARDS and ECMO

Respiratory complications are common in patients with acute brain injury and represent a significant challenge from both a respiratory and a neurological perspective. Commonly used ventilatory and non-ventilatory strategies may affect cerebral perfusion and oxygen delivery. The concomitant use of brain and general critical care ultrasound techniques aimed at monitoring cerebral perfusion and cardiorespiratory parameters at the bedside may offer a significant benefit in delivering both lung- and neuroprotective approaches in patients with complex ventilatory needs and deranged cerebrovascular physiology. In this chapter we discuss potential applications of ultrasonography for the management of patients with severe respiratory failure. Although appealing and physiologically sound, the use of ultrasound is currently supported by limited evidence and more data are needed to support its routine use in clinical practice.