Discussion issues of mechanical ventilation in patients with traumatic brain injury complicated by respiratory distress syndrome

Abstract

Based on our own observations, researches, and literature data, the modern view on the problem is discussed, and the re­levance of further study of respiratory therapy in patients with traumatic brain injury complicated by respiratory distress syndrome is substantiated, namely, the level of positive end-expiratory pressure (PEEP) in patients with intracranial hypertension, as well as the technology of selecting this parameter, because incorrect adjustment of mechanical ventilation parameters can significantly wor­sen treatment outcomes. A retrospective analysis of the results of treatment was conducted in 23 patients with traumatic brain injury (as a component of polytrauma), who were divided into two groups according to the level of PEEP. Faster neurological regression was found in patients of the first group, where PEEP was 8 ± 2 cm H2O. According to the results, it can be said that the problem of mechanical ventilation in patients with traumatic brain injury requires further study; the question of the role of cerebral and pulmonary compliance, the impact of PEEP on intracranial pressure remains unresolved.