Neuroanesthesia & neurocritical care
Neurological and respiratory effects of lung protective ventilation in acute brain injury patients without lung injury: brain vent, a single centre randomized interventional study
Authors' conclusion
The present study found that most patients did not experience any adverse effects of LPV, neither on ICP nor CA. However, in almost a quarter of patients, the ICP rose above the safety limit for interrupting the interventions.
Study context
- Population
- Intubated acute brain injury patients with normal intracranial pressure (ICP) and no lung injury27 included
- Participants
- 30 patients
- Comparison
- Low VT at low positive end-expiratory pressure (PEEP) vs high PEEP, each vs baseline ventilation
Methodological detailsprospective, single-centre, PaCO2 kept at 34-36 mmHg by adjusting respiratory rate
- Prospective
- Single-centre
- PaCO2 kept at 34-36 mmHg by adjusting respiratory rate
Primary result
As reported in the abstract
ICP change from baseline (patients without intervention interruption)
Low VT/low PEEP
2.2
mmHg
Low VT/high PEEP
2.3
mmHg
Further findings
| Outcome | Low VT/low PEEP | Low VT/high PEEP |
|---|---|---|
| Transpulmonary driving pressure± spread, kind as printed not named | 5 (SD 2) cmH2O | 5 (SD 2) cmH2O |
Predictors of interrupted events
- High baseline ICP
- P < 0.001
- Low brain compensatory reserve
- P < 0.01
- Mechanical power
- P < 0.05
Safety
ICP above safety limit (>22 mmHg for >5 min) requiring interruption of ≥1 intervention
- Patients reaching safety limit
- 6
- Of 27 included
Original publication
Neurological and respiratory effects of lung protective ventilation in acute brain injury patients without lung injury: brain vent, a single centre randomized interventional study. Crit Care. Published 20 March 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →