Efficiency of a Protective Mode of Mechanical Ventilation in Patients with Severe Traumatic Brain Injury Complicated by Acute Respiratory Distress Syndrome.

ABSTRACT:

Background/objectives

Treatment of severe traumatic brain injury (TBI) remains a major challenge in neurocritical care. The functional state of the brain largely depends on the applied ventilation strategy. Many patients develop acute respiratory distress syndrome (ARDS), for which lung-protective ventilation is recommended. However, its effect on outcomes in severe TBI remains unclear. This study aimed to assess whether a lung-protective ventilation strategy improves short-term outcomes in patients with severe TBI complicated by ARDS.

Methods

This multicenter retrospective study included patients with severe TBI and ARDS treated in three Ukrainian tertiary hospitals. Lung-protective ventilation was defined as the use of a low tidal volume and moderate positive end-expiratory pressure (PEEP). The primary endpoint was 28-day mortality; secondary endpoints included the Glasgow Coma Scale (GCS) score and intracranial pressure (ICP) on day 28. Univariate and multivariate logistic regression analyses identified factors associated with mortality.

Results

Mortality did not depend on arterial PaO₂ (p = 0.173) but correlated with lower GCS (p < 0.001), reduced PaO₂/FiO₂ ratio (p < 0.001), higher tidal volume (p < 0.001), and lower PEEP (p < 0.001). Lung-protective ventilation reduced mortality from 78.6% to 31.4%.

Conclusions

Lung-protective ventilation is safe and effective in severe TBI with ARDS, significantly improving short-term survival without compromising cerebral outcomes.

SUBMITTER: Rachel M 

PROVIDER: S-EPMC12650321 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature