Neuroanesthesia & neurocritical care
Impact of oxygen and carbon dioxide levels on mortality in moderate to severe traumatic brain injury: a systematic review and meta-analysis
Authors' conclusion
In adults with msTBI, hypoxia and hypocapnia were independently associated with increased mortality, underscoring the importance of prompt recognition and targeted management of these secondary injuries.
Study context
- Population
- Adults (≥18 years) with moderate to severe traumatic brain injury (TBI) (GCS <13 or Head Abbreviated Injury Scale ≥3)
- Participants
- 41,980 adults · 21 cohort studies
- Comparison
- Exposure to hypoxia, hypocapnia or hypercapnia vs no exposure
- Outcome
- Mortality (OR, crude and adjusted)
- Follow-up
- Within 6 months
Methodological detailsPRISMA and MOOSE guidelines, Newcastle-Ottawa Scale quality assessment, GRADE certainty of evidence, crude and adjusted effect estimates, Vegetative state data not reported; all analyses based on mortality
- PRISMA and MOOSE guidelines
- Newcastle-Ottawa Scale quality assessment
- GRADE certainty of evidence
- Crude and adjusted effect estimates
- Vegetative state data not reported; all analyses based on mortality
Pooled result
As reported in the abstract
Mortality
Adjusted odds ratio (95% CI)P value
Hypoxia
1.39(1.11–1.75)
P = 0.005Hypocapnia
1.64(1.25–2.15)
P < 0.001Hypercapnianot significantly associated with mortality
1.74(0.91–3.32)
P = 0.09Original publication
Impact of oxygen and carbon dioxide levels on mortality in moderate to severe traumatic brain injury: a systematic review and meta-analysis. Crit Care. Published 14 August 2025. doi:10.
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