Patients with acute brain injury have been excluded in the majority of the randomized clinical trials which evaluated a lung protective strategy in patients with acute respiratory failure. It remains unclear if low tidal volume, higher PEEP levels and recruitment maneuvers by increasing both the intracranial and intrathoracic pressure and by leading to a permissible hypercapnia could furthermore deteriorate the acute brain injury and the final outcome. Mechanical power has been associated with the outcome in ARDS patients without brain injury. Jiang et al. demonstrated in neurocritical patients that non-survivors had a higher mechanical power compared to survivors. Mechanical power was associated with an increase in intensive care mortality risk and also to an enhanced risk of hospital mortality, prolonged intensive care length of stay and fewer ventilatory free days; in addition, the mechanical power could better predict mortality compared to the Glasgow Coma Scale.

大多数评估急性呼吸衰竭患者肺保护策略的随机临床试验都排除了急性脑损伤患者。目前尚不清楚低潮气量、高 PEEP 水平和通过增加颅内压和胸腔内压以及导致允许的高碳酸血症而进行的复张操作是否会进一步恶化急性脑损伤和最终结果。机械功率与无脑损伤的 ARDS 患者的预后相关。姜等。在神经重症患者中证明，与幸存者相比，非幸存者具有更高的机械功率。机械功率与重症监护死亡风险增加以及住院死亡风险增加有关，延长重症监护的住院时间和减少不通气的天数；此外，与格拉斯哥昏迷量表相比，机械功率可以更好地预测死亡率。