Titre
Mechanical ventilation in patients with acute brain injury: recommendations of the European Society of Intensive Care Medicine consensus.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Robba, C.
Auteure/Auteur
Poole, D.
Auteure/Auteur
McNett, M.
Auteure/Auteur
Asehnoune, K.
Auteure/Auteur
Bösel, J.
Auteure/Auteur
Bruder, N.
Auteure/Auteur
Chieregato, A.
Auteure/Auteur
Cinotti, R.
Auteure/Auteur
Duranteau, J.
Auteure/Auteur
Einav, S.
Auteure/Auteur
Ercole, A.
Auteure/Auteur
Ferguson, N.
Auteure/Auteur
Guerin, C.
Auteure/Auteur
Siempos, I.I.
Auteure/Auteur
Kurtz, P.
Auteure/Auteur
Juffermans, N.P.
Auteure/Auteur
Mancebo, J.
Auteure/Auteur
Mascia, L.
Auteure/Auteur
McCredie, V.
Auteure/Auteur
Nin, N.
Auteure/Auteur
Oddo, M.
Auteure/Auteur
Pelosi, P.
Auteure/Auteur
Rabinstein, A.A.
Auteure/Auteur
Neto, A.S.
Auteure/Auteur
Seder, D.B.
Auteure/Auteur
Skrifvars, M.B.
Auteure/Auteur
Suarez, J.I.
Auteure/Auteur
Taccone, F.S.
Auteure/Auteur
van der Jagt, M.
Auteure/Auteur
Citerio, G.
Auteure/Auteur
Stevens, R.D.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1432-1238
Statut éditorial
Publié
Date de publication
2020-12
Volume
46
Numéro
12
Première page
2397
Dernière page/numéro d’article
2410
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
To provide clinical practice recommendations and generate a research agenda on mechanical ventilation and respiratory support in patients with acute brain injury (ABI).
An international consensus panel was convened including 29 clinician-scientists in intensive care medicine with expertise in acute respiratory failure, neurointensive care, or both, and two non-voting methodologists. The panel was divided into seven subgroups, each addressing a predefined clinical practice domain relevant to patients admitted to the intensive care unit (ICU) with ABI, defined as acute traumatic brain or cerebrovascular injury. The panel conducted systematic searches and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to evaluate evidence and formulate questions. A modified Delphi process was implemented with four rounds of voting in which panellists were asked to respond to questions (rounds 1-3) and then recommendation statements (final round). Strong recommendation, weak recommendation, or no recommendation were defined when > 85%, 75-85%, and < 75% of panellists, respectively, agreed with a statement.
The GRADE rating was low, very low, or absent across domains. The consensus produced 36 statements (19 strong recommendations, 6 weak recommendations, 11 no recommendation) regarding airway management, non-invasive respiratory support, strategies for mechanical ventilation, rescue interventions for respiratory failure, ventilator liberation, and tracheostomy in brain-injured patients. Several knowledge gaps were identified to inform future research efforts.
This consensus provides guidance for the care of patients admitted to the ICU with ABI. Evidence was generally insufficient or lacking, and research is needed to demonstrate the feasibility, safety, and efficacy of different management approaches.
An international consensus panel was convened including 29 clinician-scientists in intensive care medicine with expertise in acute respiratory failure, neurointensive care, or both, and two non-voting methodologists. The panel was divided into seven subgroups, each addressing a predefined clinical practice domain relevant to patients admitted to the intensive care unit (ICU) with ABI, defined as acute traumatic brain or cerebrovascular injury. The panel conducted systematic searches and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to evaluate evidence and formulate questions. A modified Delphi process was implemented with four rounds of voting in which panellists were asked to respond to questions (rounds 1-3) and then recommendation statements (final round). Strong recommendation, weak recommendation, or no recommendation were defined when > 85%, 75-85%, and < 75% of panellists, respectively, agreed with a statement.
The GRADE rating was low, very low, or absent across domains. The consensus produced 36 statements (19 strong recommendations, 6 weak recommendations, 11 no recommendation) regarding airway management, non-invasive respiratory support, strategies for mechanical ventilation, rescue interventions for respiratory failure, ventilator liberation, and tracheostomy in brain-injured patients. Several knowledge gaps were identified to inform future research efforts.
This consensus provides guidance for the care of patients admitted to the ICU with ABI. Evidence was generally insufficient or lacking, and research is needed to demonstrate the feasibility, safety, and efficacy of different management approaches.
PID Serval
serval:BIB_65FBD2239488
PMID
Open Access
Oui
Date de création
2020-11-16T12:32:23.886Z
Date de création dans IRIS
2025-05-20T17:04:48Z
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Nom
33175276_BIB_65FBD2239488.pdf
Version du manuscrit
published
Taille
873.72 KB
Format
Adobe PDF
PID Serval
serval:BIB_65FBD2239488.P001
URN
urn:nbn:ch:serval-BIB_65FBD22394888
Somme de contrôle
(MD5):7b56a41899e85f2e322c5a01ce37908b