Med Intensiva. 2013;37(7):485---492 www.elsevier.es/medintensiva UPDATE IN INTENSIVE CARE: NEUROINTENSIVISM Lung---brain interaction in the mechanically ventilated patient  J. López-Aguilar a,b,c,d , M.S. Fernández-Gonzalo a,e , M. Turon a,e , M.E. Quílez c , V. Gómez-Simón a,b,d , M.M. Jódar e,f , L. Blanch a,b,c,d,* , GT-IRA de la SEMICYUC a Fundació Parc Taulí, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain b Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Campus d’Excelència Internacional, Bellaterra, Barcelona, Spain c Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain d Servicio de Medicina Intensiva, Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain e Departament de Psicología Clínica i de la Salut, Universitat Autònoma de Barcelona, Campus d’ Excelència Internacional, Bellaterra, Barcelona, Spain f Servicio de Neurología, Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain Received 18 September 2012; accepted 11 October 2012 KEYWORDS Acute lung injury; Acute respiratory distress syndrome; Mechanical ventilation; Neuropsychological and cognitive impairment; Lung---brain interaction; Confusional syndrome; Delirium; Central nervous system; Intensive care unit Abstract Patients with acute lung injury or acute respiratory distress syndrome (ARDS) admit- ted to the ICU present neuropsychological alterations, which in most cases extend beyond the acute phase and have an important adverse effect upon quality of life. The aim of this review is to deepen in the analysis of the complex interaction between lung and brain in critically ill patients subjected to mechanical ventilation. This update first describes the neuropsychologi- cal alterations occurring both during the acute phase of ICU stay and at discharge, followed by an analysis of lung---brain interactions during mechanical ventilation, and finally explores the etiology and mechanisms leading to the neurological disorders observed in these patients. The management of critical patients requires an integral approach focused on minimizing the deleterious effects over the short, middle or long term. © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved. PALABRAS CLAVE Lesión pulmonar aguda; Interacción pulmón-cerebro en el paciente ventilado mecánicamente Resumen Los pacientes con lesión pulmonar aguda o síndrome de distrés respiratorio agudo (SDRA) ingresados en unidades de cuidados intensivos (UCI) presentan alteraciones neuropsi- cológicas que en la mayoría de los casos se extienden más allá de la fase aguda, acarreando  Please cite this article as: López-Aguilar J, Fernández-Gonzalo MS, Turon M, Quílez ME, Gómez-Simón V, Jódar MM, et al. Interacción pulmón-cerebro en el paciente ventilado mecánicamente. Med Intensiva. 2013;37:485---492. * Corresponding author. E-mail address: Lblanch@tauli.cat (L. Blanch). 2173-5727/$ – see front matter © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.