<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0034-7523</journal-id>
<journal-title><![CDATA[Revista Cubana de Medicina]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Cuban de Med]]></abbrev-journal-title>
<issn>0034-7523</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias MédicasEditorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0034-75232023000200003</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Efectos cerebrales del oxígeno y el dióxido de carbono en el síndrome de dificultad respiratoria aguda]]></article-title>
<article-title xml:lang="en"><![CDATA[Cerebral Effects of Oxygen and Carbon Dioxide in Acute Respiratory Distress Syndrome]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sosa Remón]]></surname>
<given-names><![CDATA[Ariel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cuba Naranjo]]></surname>
<given-names><![CDATA[Arian Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jeréz Álvarez]]></surname>
<given-names><![CDATA[Ana Esperanza]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional de Oncología y Radiobiología  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Ciencias Médicas  ]]></institution>
<addr-line><![CDATA[ Granma]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Universitario de Maracaibo  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad de Ciencias Médicas  ]]></institution>
<addr-line><![CDATA[ Granma]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital Provincial Clínico Quirúrgico Docente &#8220;Celia Sánchez Manduley&#8221;  ]]></institution>
<addr-line><![CDATA[ Granma]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2023</year>
</pub-date>
<volume>62</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-75232023000200003&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-75232023000200003&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-75232023000200003&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  El síndrome de dificultad respiratoria aguda producido por la COVID-19 provoca alteraciones en el intercambio de oxígeno y la excreción de dióxido de carbono con consecuencias neurológicas.  Objetivo:  Describir las implicaciones del oxígeno y el dióxido de carbono sobre la dinámica cerebral durante el tratamiento ventilatorio del síndrome de dificultad respiratoria aguda en el accidente cerebrovascular.  Métodos:  Se realizó una búsqueda en bases referenciales como: PubMed/Medline, SciELO, Google Académico y BVS Cuba. Los términos incluidos fueron brain-lung crosstalk, ARDS, mechanical ventilation, COVID-19 related stroke, ARDS related stroke y su traducción al español. Fueron referenciados libros de neurointensivismo y ventilación mecánica artificial. El período de búsqueda incluyó los últimos 20 años. Se seleccionaron 46 bibliografías que cumplieron con los criterios de selección.  Resultados:  Se ha descrito que los niveles de oxígeno y dióxido de carbono participan en la neurorregulación vascular en pacientes con daño cerebral. Algunas alteraciones alusivas son la vasodilatación cerebral refleja o efectos vasoconstrictores con reducción de la presión de perfusión cerebral. Como consecuencia aumenta la presión intracraneal y aparecen afectaciones neurocognitivas, isquemia cerebral tardía o herniación del tronco encefálico.  Conclusiones:  El control de la oxigenación y la excreción de dióxido de carbono resultaron cruciales para mantener la homeostasis neuronal, evita la disminución de la presión de perfusión cerebral y el aumento de la presión intracraneal. Se sugiere evitar la hipoxemia e hiperoxemia, limitar o eludir la hipercapnia y usar hiperventilación hipocápnica solo en condiciones de herniación del tallo encefálico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: The acute respiratory distress syndrome produced by COVID-19 causes alterations in the exchange of oxygen and the excretion of carbon dioxide with neurological consequences.  Objective:  To describe the implications of oxygen and carbon dioxide on brain dynamics during ventilatory treatment of acute respiratory distress syndrome in stroke.  Methods:  A search was carried out in referential bases such as PubMed/Medline, SciELO, Google Scholar and VHL Cuba. The terms included were brain-lung crosstalk, ARDS, mechanical ventilation, COVID-19 related stroke, ARDS related stroke and their translation into Spanish. Books on neurointensive care and artificial mechanical ventilation were referenced. The search period included the last 20 years. Forty six bibliographies that met the selection criteria were selected.  Results:  Oxygen and carbon dioxide levels have been described to participate in vascular neuroregulation in patients with brain damage. Some allusive alterations are reflex cerebral vasodilatation or vasoconstrictor effects with reduced cerebral perfusion pressure. As a consequence, intracranial pressure increases and neurocognitive impairments, delayed cerebral ischemia or brainstem herniation appear.  Conclusions:  The control of oxygenation and the excretion of carbon dioxide were crucial to maintain neuronal homeostasis, avoiding the decrease in cerebral perfusion pressure and the increase in intracranial pressure. It is suggested to avoid hypoxemia and hyperoxemia, limit or avoid hypercapnia, and use hypocapnic hyperventilation only in conditions of brainstem herniation.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[SDRA humano]]></kwd>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[accidente cerebrovascular]]></kwd>
<kwd lng="es"><![CDATA[ventilación mecánica]]></kwd>
<kwd lng="es"><![CDATA[hipertensión intracraneal]]></kwd>
<kwd lng="es"><![CDATA[hipoxemia]]></kwd>
<kwd lng="es"><![CDATA[CO2]]></kwd>
<kwd lng="en"><![CDATA[human ARDS]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[stroke]]></kwd>
<kwd lng="en"><![CDATA[mechanic ventilation]]></kwd>
<kwd lng="en"><![CDATA[intracranial hypertension]]></kwd>
<kwd lng="en"><![CDATA[hypoxemia]]></kwd>
<kwd lng="en"><![CDATA[CO2]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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