Ventilation practices in acute brain injured patients and association with outcomes: the VENTIBRAIN multicenter observational study
Issued Date
2025-01-01
Resource Type
ISSN
03424642
eISSN
14321238
Scopus ID
2-s2.0-86000452348
Pubmed ID
39992441
Journal Title
Intensive Care Medicine
Rights Holder(s)
SCOPUS
Bibliographic Citation
Intensive Care Medicine (2025)
Suggested Citation
Robba C., Giardiello D., Almondo C., Asehnoune K., Badenes R., Cinotti R., Elhadi M., Graziano F., Helbok R., Jiang L., Chen W., Laffey J.G., Messina A., Putensen C., Schultz M.J., Wahlster S., Rebora P., Galimberti S., Taccone F.S., Citerio G., Godoy D., Cai S., Alrayes B.M.H., Felipez T.H., Khamees A., Henzler D., Al-juaifari M.A., Liu J., Suarez J.I., Bower M., Cho S.M., Rivera-Chávez M.J., Gomà G., Petrun A.M., Alsharif M., Al-Touny A., Elsahli S., Mohammed Y.M.I., Wu W., Elsaadany R., Nita C., Hanley C., Babu I., Balasubramanian M., Manohara N., Tang R., Zhou M., Shama M., Nasreddin M., Elbahnasawy M., Recasens A., de Peray C., Zattera L., Ferrando C., Ren R., Li Y., Feng G., Chen M., Chen H., Brandejs O., Spatenkova V., Francony G., Schilte C., Gritti P., Micheli F., Altaweel N.M., Wang J., Tahsili-Fahadan P., Gelormini C., Pisapia L., Caricato A., Viñán-Garcés E., Olivella-Gomez J., Siddiqui Z., Rao S., Hunain R., Alaa A.R., Shemeis M., Elwany A., Abdussalam A.L., Solanki F., Iqbal P., Elmelliti H., Romero-García N., Monleón B., Gottin L., Liviero M.C., Gelormini D., Estera H., Michele B.Z., Piergiorgio L., Alday U.A.K.A., Bannaga H.A., Eltayeb E.E.A.B.H., Hobart P., Felli A., Krenn K., Cinotti R., Roquilly A., Hourmant Y. Ventilation practices in acute brain injured patients and association with outcomes: the VENTIBRAIN multicenter observational study. Intensive Care Medicine (2025). doi:10.1007/s00134-025-07808-1 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/106776
Title
Ventilation practices in acute brain injured patients and association with outcomes: the VENTIBRAIN multicenter observational study
Author(s)
Robba C.
Giardiello D.
Almondo C.
Asehnoune K.
Badenes R.
Cinotti R.
Elhadi M.
Graziano F.
Helbok R.
Jiang L.
Chen W.
Laffey J.G.
Messina A.
Putensen C.
Schultz M.J.
Wahlster S.
Rebora P.
Galimberti S.
Taccone F.S.
Citerio G.
Godoy D.
Cai S.
Alrayes B.M.H.
Felipez T.H.
Khamees A.
Henzler D.
Al-juaifari M.A.
Liu J.
Suarez J.I.
Bower M.
Cho S.M.
Rivera-Chávez M.J.
Gomà G.
Petrun A.M.
Alsharif M.
Al-Touny A.
Elsahli S.
Mohammed Y.M.I.
Wu W.
Elsaadany R.
Nita C.
Hanley C.
Babu I.
Balasubramanian M.
Manohara N.
Tang R.
Zhou M.
Shama M.
Nasreddin M.
Elbahnasawy M.
Recasens A.
de Peray C.
Zattera L.
Ferrando C.
Ren R.
Li Y.
Feng G.
Chen M.
Chen H.
Brandejs O.
Spatenkova V.
Francony G.
Schilte C.
Gritti P.
Micheli F.
Altaweel N.M.
Wang J.
Tahsili-Fahadan P.
Gelormini C.
Pisapia L.
Caricato A.
Viñán-Garcés E.
Olivella-Gomez J.
Siddiqui Z.
Rao S.
Hunain R.
Alaa A.R.
Shemeis M.
Elwany A.
Abdussalam A.L.
Solanki F.
Iqbal P.
Elmelliti H.
Romero-García N.
Monleón B.
Gottin L.
Liviero M.C.
Gelormini D.
Estera H.
Michele B.Z.
Piergiorgio L.
Alday U.A.K.A.
Bannaga H.A.
Eltayeb E.E.A.B.H.
Hobart P.
Felli A.
Krenn K.
Cinotti R.
Roquilly A.
Hourmant Y.
Giardiello D.
Almondo C.
Asehnoune K.
Badenes R.
Cinotti R.
Elhadi M.
Graziano F.
Helbok R.
Jiang L.
Chen W.
Laffey J.G.
Messina A.
Putensen C.
Schultz M.J.
Wahlster S.
Rebora P.
Galimberti S.
Taccone F.S.
Citerio G.
Godoy D.
Cai S.
Alrayes B.M.H.
Felipez T.H.
Khamees A.
Henzler D.
Al-juaifari M.A.
Liu J.
Suarez J.I.
Bower M.
Cho S.M.
Rivera-Chávez M.J.
Gomà G.
Petrun A.M.
Alsharif M.
Al-Touny A.
Elsahli S.
Mohammed Y.M.I.
Wu W.
Elsaadany R.
Nita C.
Hanley C.
Babu I.
Balasubramanian M.
Manohara N.
Tang R.
Zhou M.
Shama M.
Nasreddin M.
Elbahnasawy M.
Recasens A.
de Peray C.
Zattera L.
Ferrando C.
Ren R.
Li Y.
Feng G.
Chen M.
Chen H.
Brandejs O.
Spatenkova V.
Francony G.
Schilte C.
Gritti P.
Micheli F.
Altaweel N.M.
Wang J.
Tahsili-Fahadan P.
Gelormini C.
Pisapia L.
Caricato A.
Viñán-Garcés E.
Olivella-Gomez J.
Siddiqui Z.
Rao S.
Hunain R.
Alaa A.R.
Shemeis M.
Elwany A.
Abdussalam A.L.
Solanki F.
Iqbal P.
Elmelliti H.
Romero-García N.
Monleón B.
Gottin L.
Liviero M.C.
Gelormini D.
Estera H.
Michele B.Z.
Piergiorgio L.
Alday U.A.K.A.
Bannaga H.A.
Eltayeb E.E.A.B.H.
Hobart P.
Felli A.
Krenn K.
Cinotti R.
Roquilly A.
Hourmant Y.
Author's Affiliation
Hôpital Universitaire de Bruxelles (HUB)
Mahidol Oxford Tropical Medicine Research Unit
Kepler Universitätsklinikum
IRCCS San Martino Polyclinic Hospital
Xuanwu Hospital, Capital Medical University
University of Al-Fateh Faculty of Medicine
University Hospital Galway
Universitätsklinikum Bonn
Hôtel Dieu CHU de Nantes
Università degli Studi di Genova
Humanitas Research Hospital
University of Washington
Hospital Clinico Universitario de Valencia
Fondazione IRCCS San Gerardo dei Tintori
Università degli Studi di Milano-Bicocca
Medizinische Universität Wien
Nuffield Department of Medicine
Medizinische Universitat Innsbruck
Amsterdam UMC - University of Amsterdam
Mahidol Oxford Tropical Medicine Research Unit
Kepler Universitätsklinikum
IRCCS San Martino Polyclinic Hospital
Xuanwu Hospital, Capital Medical University
University of Al-Fateh Faculty of Medicine
University Hospital Galway
Universitätsklinikum Bonn
Hôtel Dieu CHU de Nantes
Università degli Studi di Genova
Humanitas Research Hospital
University of Washington
Hospital Clinico Universitario de Valencia
Fondazione IRCCS San Gerardo dei Tintori
Università degli Studi di Milano-Bicocca
Medizinische Universität Wien
Nuffield Department of Medicine
Medizinische Universitat Innsbruck
Amsterdam UMC - University of Amsterdam
Corresponding Author(s)
Other Contributor(s)
Abstract
Purpose: Current mechanical ventilation practices for patients with acute brain injury (ABI) are poorly defined. This study aimed to describe ventilator settings/parameters used in intensive care units (ICUs) and evaluate their association with clinical outcomes in these patients. Methods: An international, prospective, multicenter, observational study was conducted across 74 ICUs in 26 countries, including adult patients with ABI (e.g., traumatic brain injury, intracranial hemorrhage, subarachnoid hemorrhage, and acute ischemic stroke), who required ICU admission and invasive mechanical ventilation. Ventilatory settings were recorded daily during the first week and on days 10 and 14. ICU and 6-months mortality and 6-months neurological outcome were evaluated. Results: On admission, 2095 recruited patients (median age 58 [interquartile range 45–70] years, 66.1% male) had a median plateau pressure (Pplat) of 15 (13–18) cmH20, tidal volume/predicted body weight 6.5 (5.7–7.3) mL/Kg, driving pressure 9 (7–12) cmH20, and positive end-expiratory pressure 5 (5–8) cmH20, with no modifications in case of increased intracranial pressure (> 20 mmHg). Significant differences in practices were observed across different countries. The majority of these ventilatory settings were associated with ICU mortality, with the highest hazard ratio (HR) for Pplat (odds ratio 1.50; 95% confidence interval, CI: 1.27–1.78). The results demonstrated consistent association with 6-month mortality; less clear association was observed for neurological outcome. Conclusions: 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.