Intracranial response to positive end-expiratory pressure is influenced by lung recruitability and gas distribution during mechanical ventilation in acute brain injury patients: a proof-of-concept physiological study

Patients with a higher potential for lung recruitability had a more beneficial effect of PEEP on oxygenation. These effects should be interpreted cautiously, given that lung recruitability and global inhomogeneity of gas distribution significantly influenced the intracranial response to PEEP in ABI patients. As indicated by MAP and CPP, PEEP may impact systemic haemodynamics and cerebral perfusion when cerebral autoregulation is deranged. These findings underscore the importance of multimodal (i.e. respiratory, cerebral and haemodynamics) monitoring for optimising ventilation strategies in ABI patients and provide a framework for future research. Trial registration Registration number: NCT05363085, Date of registration: May 2022.

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Publication Details

Journal
Intensive Care Medicine Experimental
Published
2025-04-14
DOI
https://doi.org/10.1186/s40635-025-00750-y
Citations
9
Primary Topic
Traumatic Brain Injury and Neurovascular Disturbances
Type
article
Field-Weighted Citation Impact
12.50

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article

Intracranial response to positive end-expiratory pressure is influenced by lung recruitability and gas distribution during mechanical ventilation in acute brain injury patients: a proof-of-concept physiological study

Rafael Kawati, Anders Lewén, Anders Hånell, Henrik Engquist et al.
9 citations
Intensive Care Medicine Experimental
Traumatic Brain Injury and Neurovascular Disturbances
12.50
article

Intracranial response to positive end-expiratory pressure is influenced by lung recruitability and gas distribution during mechanical ventilation in acute brain injury patients: a proof-of-concept physiological study

Rafael Kawati, Anders Lewén, Anders Hånell, Henrik Engquist, Filip Fredén, Gaetano Perchiazzi, Annelie Barrueta Tenhunen, Odin Joensen, Laurent Brochard, Kristin Jona Bjarnadottir, Per Enblad, Mariangela Pellegrini, Reka Bencze
article en
9 citations

Abstract

Patients with a higher potential for lung recruitability had a more beneficial effect of PEEP on oxygenation. These effects should be interpreted cautiously, given that lung recruitability and global inhomogeneity of gas distribution significantly influenced the intracranial response to PEEP in ABI patients. As indicated by MAP and CPP, PEEP may impact systemic haemodynamics and cerebral perfusion when cerebral autoregulation is deranged. These findings underscore the importance of multimodal (i.e. respiratory, cerebral and haemodynamics) monitoring for optimising ventilation strategies in ABI patients and provide a framework for future research. Trial registration Registration number: NCT05363085, Date of registration: May 2022.

Intensive Care Medicine ExperimentalVol. 13(1)
Uppsala University (SE), St. Michael's Hospital (CA), Uppsala University Hospital (SE)
Svenska Sällskapet för Medicinsk Forskning, Hjärt-Lungfonden, Vetenskapsrådet, Akademiska Sjukhuset, Uppsala Universitet, Svenska Läkaresällskapet, Norsk Institutt for Vannforskning
Openalex Percentile: Top 1%
Traumatic Brain Injury and Neurovascular Disturbances
12.50
DOIOpen Access PDFOpenAlex
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