Trial reportCritical care (London, England)2023
Neurological and respiratory effects of lung protective ventilation in acute brain injury patients without lung injury: brain vent, a single centre randomized interventional study.
Trial report in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03278769 (Relation Between Lung Protective Mechanical Ventilation, Intracranial Pressure, Autoregulation and Brain Oxygenation in Neurointensive Care Patients), which is not on this map. Cited by 24 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Relation Between Lung Protective Mechanical Ventilation, Intracranial Pressure, Autoregulation and Brain Oxygenation in Neurointensive Care Patients
Who cites it
24 citing papers in PubMed, 39 citations in OpenAlex.
- 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
- Balancing lung and brain: physiological strategies for ARDS management in acute brain injury.Intensive care medicine · 2026Review
- Ventilator-Induced Signal Interference and the Accuracy of the Pressure Reactivity Index in Acute Brain Injury.Neurocritical care · 2026Article
- Burden of and risk factors for neurological complications in critical illness.Intensive care medicine · 2026Review
- Impact of positive end-expiratory pressure on autonomic nervous system activity and its interaction with cerebrovascular reactivity - an experimental study.Journal of clinical monitoring and computing · 2026Article
- Temporal Dynamics of Cerebral Autoregulation after Aneurysmal Subarachnoid Hemorrhage: Insights from Pressure Reactivity Index and Non-injured Controls.Neurology and therapy · 2026Article
- A nomogram for predicting the risk of acute respiratory distress syndrome in patients with severe acute brain injury.BMC neurology · 2026Article
- Positive end-expiratory pressure increases intracranial pressure but does not affect PRx, regardless of body position, in a porcine ARDS model.Frontiers in physiology · 2026Article
- First Breath Matters: Out-of-Hospital Mechanical Ventilation in Patients with Traumatic Brain Injury.Journal of clinical medicine · 2025Review
- Observational
- Update on traumatic brain injury in the ICU.Current opinion in anaesthesiology · 2025Review
- Review of Ventilation in Traumatic Brain Injury.Respiratory care · 2025Review
- Management of severe traumatic brain injury in pediatric patients: an evidence-based approach.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- VENTIlatory strategies for patients with severe traumatic brain injury in the LOw- and Middle-Income CountrieS. The VENTILOMICS survey.Critical care science · 2025Article
- Total Antioxidant Status in Critically Ill Patients with Traumatic Brain Injury and Secondary Organ Failure-A Systematic Review.Diagnostics (Basel, Switzerland) · 2024Review
- Does Lung Protective Ventilation Work in Acute Brain Injury?American journal of respiratory and critical care medicine · 2024Article
- Driving pressure: A useful tool for reducing postoperative pulmonary complications.World journal of critical care medicine · 2024Article
- Effects of positive end-expiratory pressure on intracranial pressure, cerebral perfusion pressure, and brain oxygenation in acute brain injury: Friend or foe? A scoping review.Journal of intensive medicine · 2024Article
- Advanced neuromonitoring powered by ICM+ and its place in the Brand New AI World, reflections at the 20th anniversary boundary.Brain & spine · 2024Article
- Reliability and variability of pressure reactivity index (prx) during oscillatory pattern in arterial blood pressure and intracranial pressure in traumatic brain injured patients.Brain & spine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
Abstract
introductionLung protective ventilation (LPV) comprising low tidal volume (VT) and high positive end-expiratory pressure (PEEP) may compromise cerebral perfusion in acute brain injury (ABI). In patients with ABI, we investigated whether LPV is associated with increased intracranial pressure (ICP) and/or deranged cerebral autoregulation (CA), brain compensatory reserve and oxygenation.
methodsIn a prospective, crossover study, 30 intubated ABI patients with normal ICP and no lung injury were randomly assigned to receive low VT [6 ml/kg/predicted (pbw)]/at either low (5 cmH
resultsWe included 27 patients (intracerebral haemorrhage, traumatic brain injury, subarachnoid haemorrhage), of whom 6 reached the safety limit, which required interruption of at least one intervention. For those without intervention interruption, the ICP change from baseline to "low VT/low PEEP" and "low VT/high PEEP" were 2.2 mmHg and 2.3 mmHg, respectively, and considered clinically non-relevant. None of the interventions affected CA or oxygenation significantly. Interrupted events were associated with high baseline ICP (p < 0.001), low brain compensatory reserve (p < 0.01) and mechanical power (p < 0.05). The transpulmonary driving pressure was 5 ± 2 cmH
conclusionsThe 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. Baseline ICP, brain compensatory reserve, and mechanical power can predict a potentially deleterious effect of LPV and can be used to personalize ventilator settings. Trial registration NCT03278769 . Registered September 12, 2017.
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Registered trials
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.