Neuroanaesthesia & neurocritical care
Respiratory mechanics modifies the impact of ventilator settings on clinical outcome in patients with acute brain injury
Authors' conclusion
The impact of ventilator settings is modulated by ERS.
Study context
- Population
- Mechanically ventilated patients with acute brain injury
- Participants
- 1,158 participants
- Comparison
- Associations of VT and respiratory rate with outcomes across respiratory system elastance (ERS)
- Primary endpoint
- ICU mortality (association of higher VT, by ERS)
Methodological detailspost hoc analysis, effect modification analysis
- Post hoc analysis
- Effect modification analysis
Primary result
As reported in the abstract
ICU mortality with higher VT
Odds ratio (95% CI)
Low ERShigher VT associated with lower ICU mortality
0.52(0.36–0.74)
High ERSno association
1.16(0.89–1.51)
Further findings
VT and ΔP across ERS tertiles
- VT similar across ERS tertiles (median, mL/kg)
- 7.9, 7.6 and 7.1
- ΔP across ERS tertiles (median, cmH2O)
- 5, 9, and 12
Respiratory rate
- Higher respiratory rate associated with worse outcomes, particularly at low ERS, attenuating at higher ERS
Bayesian optimal VT/PBW and respiratory rate
- Optimal VT/PBW at ERS 0.5 cmH2O/(mL/kg) (≈ ΔP 6 cmH2O)
- 11.4 mL/kg
- Optimal VT/PBW at ERS 2.5 cmH2O/(mL/kg) (≈ ΔP 11 cmH2O)
- 4.4 mL/kg
- Optimal respiratory rate increased (breaths/min)
- 15 to 19
ΔP vs respiratory rate trade-off at constant alveolar ventilation
- 1-cmH2O ΔP increase comparable prognostic impact to respiratory rate increase (breaths/min)
- ≈ 3
ARDS diagnosis (subgroup)
- Results consistent irrespective of ARDS diagnosis
Original publication
Respiratory mechanics modifies the impact of ventilator settings on clinical outcome in patients with acute brain injury. Intensive Care Med. Published 19 August 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →