| Abstract [eng] |
Background: Traumatic brain injuries are receiving increasing attention due to the rising number of cases and often unfavorable treatment outcomes. Given the typically severe nature of this condition, which frequently complicates with acute respiratory failure, these patients require admission to an intensive care unit and treatment with mechanical ventilation. Objectives: To evaluate the safety of adaptive support ventilation in the traumatic brain injury patient population and to summarize the most recent data on mechanical ventilation strategies for patients with traumatic brain injury and acute respiratory failure, following a literature review. Methods: A non-systematic literature review and a prospective observational study were conducted. Inclusion criteria for the study: patients aged ≥ 18 years old, who had experienced traumatic brain injury, had no concurrent pulmonary pathology, were ventilated with Hamilton S1 ventilators, and utilized IntelliVent®-ASV mode and IntelliSync+ tool for a minimum duration of 48 hours. Ventilation parameters were continuously monitored, recorded in real-time, and stored in a computer database using Acrux DeepBreath software. Data review, artifact removal, data analysis, and result calculation were carried out using Microsoft Excel. Results: The study included 17 patients who met the specified inclusion criteria. The total ventilation time for all patients was 2091 h 1 min (from 48 h 5 min to 289 h 04 min for individual patients). After removing 2.5% of the respiratory cycles identified as artifacts, a total of 2235006 respiratory cycles were included in analysis. 94.58% of all patients' respiratory cycles (ranging from a min of 83.15% to a max of 99.84% per patient) met the criteria for lung-protective ventilation. During the initial 48 hours of ventilation, the observed ventilation parameters were optimal. Conclusions: Currently, there are no precise, universally accepted guidelines for the use of lung-protective ventilation in managing patients with traumatic brain injury and acute respiratory failure. Due to the complex interaction between the brain and the lungs, such patients are usually not included in studies examining mechanical ventilation concerns and strategies. Nevertheless, the use of lung-protective ventilation is recommended for this group of patients. This study concluded that the IntelliVent®-ASV mode offers patients with traumatic brain injury lung-protective ventilation and personalized care, while also reducing the workload for intensive care unit staff. |
