Neuroprotective Mechanical Ventilation Strategies in Brain-Injured Patients.

Mechanical ventilation presents a unique challenge in acute brain injury, as lung-protective strategies may adversely affect cerebral physiology. Acute brain injury encompasses a heterogeneous spectrum of disorders with dynamic pathophysiology, precluding uniform ventilatory protocols. The concepts of ventilator-associated brain injury and brain-lung crosstalk underscore the bidirectional impact of mechanical ventilation on pulmonary and neuronal integrity, even in the absence of primary brain pathology but particularly when acute brain injury is present. This article summarizes current evidence on lung-protective ventilation and its cerebral effects, emphasizing high-risk populations. Future research should refine integrated brain-lung protective strategies tailored to each patient's physiologic profile.