Neuroanesthesia & neurocritical care
Ventilation practices in acute brain injured patients and association with outcomes: the VENTIBRAIN multicenter observational study
An erratum to this article was published (Intensive Care Med, Aug 2025 ↗)
Authors' conclusion
Protective ventilation strategies are commonly used in ABI patients but with high variability across different countries. Ventilator settings during ICU stay were associated with an increased risk of ICU and 6-month mortality, but not an unfavorable neurological outcome.
Study context
- Population
- Adults with acute brain injury (e.g., TBI, intracranial haemorrhage, SAH, acute ischaemic stroke) requiring ICU admission and invasive mechanical ventilation, 74 intensive care units (ICUs) in 26 countries
- Participants
- 2,095 adults · 74 ICUs · 26 countries
- Outcome
- Ventilator settings on admission
- Follow-up
- Admission
Methodological detailsinternational, multicentre, Ventilatory settings recorded daily during the first week and on days 10 and 14
- International
- Multicentre
- Ventilatory settings recorded daily during the first week and on days 10 and 14
Main finding
As reported in the abstract
Plateau pressure, median (IQR), cmH20
15
13–18
Tidal volume/predicted body weight, median (IQR), mL/Kg
6.5
5.7–7.3
Driving pressure, median (IQR), cmH20
9
7–12
PEEP, median (IQR), cmH20
5
5–8
Observational data: associations, not effects.
Further findings
ICU mortality by ventilator settings
| OR (95% CI) | ||
|---|---|---|
| Pplat | 1.50 (1.27–1.78) | |
| 0.512Odds ratio (log scale) |
- ICU mortality by ventilator settings: highest effect among settings; abstract labels it both HR and OR
ICU mortality by ventilator settings
- Majority of ventilatory settings associated with ICU mortality
6-month mortality and neurological outcome
- Consistent association of ventilator settings with 6-month mortality
- Less clear association with neurological outcome
Original publication
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