Respiratory failure & ventilation
Ventilatory Management in Neurocritical Versus Non-Neurocritical Care Patients: A Pooled Analysis From the PRIME Database
Authors' conclusion
In this cohort, ventilatory management at the initial and 48-hour assessments differed between neurocritical care and non-neurocritical care patients, particularly with respect to key ventilator settings like Vt, positive end-expiratory pressure, and Fio2. In neurocritical care patients, ARDS was more often diagnosed than in non-neurocritical care patients.
Study context
- Population
- Invasively ventilated critically ill neurocritical care and non-neurocritical care patients without acute respiratory distress syndrome (ARDS) at the start of ventilation, from the PRoVENT, PRoVENT-iMiC and ENIO studiesincluded in the analysis · neurocritical care 1,702 · non-neurocritical care 1,920
- Participants
- 3,848 participants
- Comparison
- Neurocritical care vs non-neurocritical care patients
- Neurocritical care patientsn = 1,702
- Non-neurocritical care patientsn = 1,920
- Outcome
- Diagnosis of ARDS after initiation of invasive ventilation
Methodological detailsPRIME database
- PRIME database
Pooled result
As reported in the abstract
P < 0.001
Further pooled results
ICU mortality (secondary endpoint) · ICU mortality lower in neurocritical care patients
P < 0.001
Ventilator settings and derived parameters · both assessed time points
- Neurocritical care patients received lower median Vts, positive end-expiratory pressure, and Fio2, and had lower median ΔP, mechanical power (MP) and ventilatory ratio and higher respiratory system compliance than non-neurocritical care patients
- Differences consistently observed at both assessed time points
Ventilation among neurocritical care patients who developed ARDS (subgroup)
- Among neurocritical care patients, those who developed ARDS were ventilated with lower median Vt and higher Fio2 and had higher median ΔP and MP
- Vt normalized for predicted body weight in neurocritical care patients independently associated with the development of ARDS
Original publication
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