ArticleIntensive care medicine2017
A multi-faceted strategy to reduce ventilation-associated mortality in brain-injured patients. The BI-VILI project: a nationwide quality improvement project.
Article in Intensive care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01885507 (Duration of Mechanical Ventilation and Mortality Among Brain-injured Patients - a Before-after Evaluation of a Quality Improvement Project), which is not on this map. Cited by 51 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Duration of Mechanical Ventilation and Mortality Among Brain-injured Patients - a Before-after Evaluation of a Quality Improvement Project
Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Mechanical ventilation in patients with acute brain injury: a systematic review with meta-analysis.Critical care (London, England) · 2023Pooled it
- Mechanical ventilation in aneurysmal subarachnoid hemorrhage: systematic review and recommendations.Critical care (London, England) · 2020Pooled it
- Association between continuous hyperosmolar therapy and survival in patients with traumatic brain injury - a multicentre prospective cohort study and systematic review.Critical care (London, England) · 2017Pooled it
- The Neurological and Hemodynamics Safety of an Airway Clearance Technique in Patients with Acute Brain Injury: An Analysis of Intracranial Pressure Pulse Morphology Using a Non-Invasive Sensor.Sensors (Basel, Switzerland) · 2024Trial
- Neurological and respiratory effects of lung protective ventilation in acute brain injury patients without lung injury: brain vent, a single centre randomized interventional study.Critical care (London, England) · 2023Trial
- Cortisol total/CRP ratio for the prediction of hospital-acquired pneumonia and initiation of corticosteroid therapy in traumatic brain-injured patients.Critical care (London, England) · 2019Trial
- Trial
- Balancing lung and brain: physiological strategies for ARDS management in acute brain injury.Intensive care medicine · 2026Review
- First Breath Matters: Out-of-Hospital Mechanical Ventilation in Patients with Traumatic Brain Injury.Journal of clinical medicine · 2025Review
- Observational
- Pathophysiology and clinical applications of PEEP in acute brain injury.Intensive care medicine · 2025Review
- Efficiency of a Protective Mode of Mechanical Ventilation in Patients with Severe Traumatic Brain Injury Complicated by Acute Respiratory Distress Syndrome.Brain sciences · 2025Article
- Beyond the bleed: complications after aneurysmal subarachnoid hemorrhage. Pathophysiology, clinical implications, and management strategies: a review.Critical care (London, England) · 2025Review
- Spontaneous subarachnoid hemorrhage: A primer for acute care practitioners.Journal of the Intensive Care Society · 2025Review
- The construction of a risk prediction model for the impact of tidal volume in postoperative patients with intracerebral hemorrhage using neural-assisted mechanical ventilation based on columnar graph.BMC anesthesiology · 2025Article
- Review of Ventilation in Traumatic Brain Injury.Respiratory care · 2025Review
- High-Grade Subarachnoid Hemorrhage - Beyond Guidelines.Neurologic clinics · 2025Review
- Managing Intracranial Pressure Crisis.Current neurology and neuroscience reports · 2024Review
- Article
- Standard versus individualised positive end-expiratory pressure (PEEP) compared by electrical impedance tomography in neurocritical care: a pilot prospective single centre study.Intensive care medicine experimental · 2024Article
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Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units.
methodsProspective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French intensive care units (ICUs) were included. The management of invasive ventilation in brain-injured patients admitted between 1 July 2013 and 31 October 2013 (4 months) was monitored and analysed. After the baseline period (1 November 2013-31 December 2013), ventilator settings and decision to extubate were selected as targets to hasten weaning from invasive ventilation. During the intervention period, low tidal volume (≤7 ml/kg), moderate positive end-expiratory pressure (PEEP, 6-8 cm H
resultsA total of 744 patients from 20 ICUs were included (391 pre-intervention; 353 intervention). No difference in the number of invasive ventilation-free days at day 90 was observed between the two periods [71 (0-80) vs. 67 (0-80) days; P = 0.746]. Compliance with the complete set of recommendations increased from 8 (2%) to 52 (15%) patients after the intervention (P < 0.001). At day 90, the number of invasive ventilation-free days was higher in the 60 (8%) patients whose care complied with recommendations than in the 684 (92%) patients whose care deviated from recommendations [77 (66-82) and 71 (0-80) days, respectively; P = 0.03]. The mortality rate was 10% in the compliant group and 26% in the non-compliant group (P = 0.023). Both multivariate analysis [hazard ratio (HR) 1.78, 95% confidence interval (95% CI) 1.41-2.26; P < 0.001] and propensity score-adjusted analysis (HR 2.25, 95% CI 1.56-3.26, P < 0.001) revealed that compliance was an independent factor associated with the reduction in the duration of mechanical ventilation.
conclusionsAdherence to recommendations for low tidal volume, moderate PEEP and early extubation seemed to increase the number of ventilator-free days in brain-injured patients, but inconsistent adoption limited their impact. Trail registration number: NCT01885507.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.