biostudies-literatureUnknown15(11)Rachel M<h4>Background/objectives</h4>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.<h4>Methods</h4>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.<h4>Results</h4>Mortality did not depend on arterial PaO₂ (<i>p</i> = 0.173) but correlated with lower GCS (<i>p</i> < 0.001), reduced PaO₂/FiO₂ ratio (<i>p</i> < 0.001), higher tidal volume (<i>p</i> < 0.001), and lower PEEP (<i>p</i> < 0.001). Lung-protective ventilation reduced mortality from 78.6% to 31.4%.<h4>Conclusions</h4>Lung-protective ventilation is safe and effective in severe TBI with ARDS, significantly improving short-term survival without compromising cerebral outcomes.Brain sciences1151https://www.ebi.ac.uk/biostudies/studies/S-EPMC12650321biostudies-literatureEfficiency of a Protective Mode of Mechanical Ventilation in Patients with Severe Traumatic Brain Injury Complicated by Acute Respiratory Distress Syndrome.PMC12650321Yaroslavska SDobrorodniy AKrenov KRachel MOliynyk OMamonowa MfalseEfficiency of a Protective Mode of Mechanical Ventilation in Patients with Severe Traumatic Brain Injury Complicated by Acute Respiratory Distress Syndrome.<h4>Background/objectives</h4>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.<h4>Methods</h4>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.<h4>Results</h4>Mortality did not depend on arterial PaO₂ (<i>p</i> = 0.173) but correlated with lower GCS (<i>p</i> < 0.001), reduced PaO₂/FiO₂ ratio (<i>p</i> < 0.001), higher tidal volume (<i>p</i> < 0.001), and lower PEEP (<i>p</i> < 0.001). Lung-protective ventilation reduced mortality from 78.6% to 31.4%.<h4>Conclusions</h4>Lung-protective ventilation is safe and effective in severe TBI with ARDS, significantly improving short-term survival without compromising cerebral outcomes.2025-01-01T00:00:00Z2025 Oct2026-05-20T03:17:39.727Z2026-05-20T03:13:16.256ZS-EPMC126503214130015910.3390/brainsci15111151