Evidence map›Paper›PMID 41537840›Full record

Observational studyIntensive care medicine2026

Dynamic driving pressure and clinical outcomes in mechanically ventilated patients with acute brain injury: a secondary analysis of the VENTIBRAIN study

Shaurya Taran, Giuseppe Citerio, Fabio S Taccone, Emanuele Rezoagli, Kuan Liu, Victoria A McCredie, John G Laffey, Lorenzo Calabro, Nicolo A Patroniti, Francesca Graziano and 4 more

Registry-linked trialAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04459884 (Multicenter Observational Study on Practice of Ventilation in Brain Injured Patients), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

NCT04459884 completednot on this map

Multicenter Observational Study on Practice of Ventilation in Brain Injured Patients

Typeobservational_patient_registrySponsorUniversity of Milano BicoccaRan2021 to 2024Enrolled2,299ConditionsMechanical Ventilation, Acute Brain InjuryArmsmechanical ventilation
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Shaurya TaranInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto Western Hospital, Toronto, Canada. shaurya.taran@mail.utoronto.ca.ORCID 0000-0001-7639-0365
Giuseppe CiterioSchool of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Fabio S TacconeDepartment of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
Emanuele RezoagliSchool of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Kuan LiuInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
Victoria A McCredieInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto Western Hospital, Toronto, Canada.
John G LaffeyAnesthesia and Intensive Care Medicine, School of Medicine, University of Galway, Galway, Ireland.
Lorenzo CalabroDepartment of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
Nicolo A PatronitiDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
Francesca GrazianoFondazione IRCCS San Gerardo Dei Tintori, Monza, Italy.
Paola ReboraFondazione IRCCS San Gerardo Dei Tintori, Monza, Italy.
Chiara Robba *Department of Surgical Science and Integrated Diagnostic, University of Genoa, Genoa, Italy.
Neill K J Adhikari *Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto Western Hospital, Toronto, Canada.
VENTIBRAIN study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo investigate the association between dynamic driving pressure (ΔPdyn) and mortality in mechanically ventilated patients with acute brain injury (ABI), and to evaluate whether neurological and pulmonary injury severity modify this relationship.

methodsThis prespecified secondary analysis of the VENTIBRAIN prospective study (NCT04459884) included mechanically ventilated adult patients with ABI (traumatic brain injury, subarachnoid hemorrhage, intracranial hemorrhage, or ischemic stroke). ΔPdyn was calculated daily over the first 14 days as peak inspiratory pressure minus positive end-expiratory pressure (PEEP). Bayesian joint models evaluated the time-varying association between ΔPdyn and mortality at ICU discharge, hospital discharge, and 6 months. Secondary analyses evaluated effect modification by baseline Glasgow Coma Scale (GCS), PaO₂/FiO₂, and ABI subtype.

resultsAmong 1,555 patients (median age 59 years, 34.5% female), higher time-varying ΔPdyn was associated with increased ICU mortality (hazard ratio [HR], 1.057 per daily 1cmH

conclusionHigher time-varying ΔPdyn was associated with increased mortality in this cohort of patients with ABI. Neurological injury severity independently modified the harm from ΔPdyn with a magnitude comparable to severe hypoxemia. Measurement of ΔPdyn may aid risk stratification and ventilation strategies in ABI; future trials should evaluate the effect of reducing ΔPdyn in this population.

Indexed as

Brain InjuriesRespiration, ArtificialAdultAgedBayes TheoremFemaleGlasgow Coma ScaleHumansIntensive Care UnitsMaleMiddle AgedPositive-Pressure RespirationProspective StudiesAcute brain injuryDriving pressureLung protective ventilationVentilator-associated brain injuryVentilator-induced lung injury

Identifiers

PMID41537840

What OpenQuestion holds

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Read underepoch 390

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.