Mechanical Ventilation in Traumatic/Acute Brain Injury

Acute respiratory distress syndrome (ARDS) is the most common nonneurologic organ dysfunction in severe acute brain injury patients. Cross talk between the brain and lung is a culprit for acute lung injury (ALI). Although robust or scientific evidence on recommendations about mechanical ventilation in acute brain injury (ABI) is lacking, recommendations are made after the collective opinion of an expert panel. For intubation and ventilation factors, such as neurological severity (Glass Coma Scale [GCS]), presence of protective reflexes, raised intracranial pressure (ICP), and the presence of ARDS should be considered. The probable course of neurological worsening, the need for surgery or interventional management, and associated nonneurological illness/injury to other organs need to be considered.