{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:40:11Z","timestamp":1756323611564,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,10,24]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p>The BOOST-2 trial indicated that optimising brain oxygen (PbtO2) could be a viable therapeutic target for severe traumatic brain injury (sTBI). Previous studies have suggested the safety of airway pressure release ventilation (APRV) in sTBI patients, but its effect on PbtO2 has not been demonstrated. This study is aimed to show that APRV can improve PbtO2 in sTBI patients. In a retrospective case series, two sTBI patients with controlled intracranial pressures developed refractory hypoxemia and brain hypoxia, unresponsive to traditional therapies. Treated with APRV, both patients showed improved hypoxemia and increased PbtO2 levels above 20\u2009mm Hg without adverse effects on intracranial pressure. They recovered from hypoxemia, transitioned to assist-controlled ventilation and were discharged to rehabilitation. These cases suggest that APRV can safely and effectively improve PbtO2 in sTBI patients when other treatments fail, warranting further exploration pending results from the ongoing BOOST-3 trial.<\/jats:p>","DOI":"10.1136\/bcr-2024-261565","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T02:20:28Z","timestamp":1731032428000},"page":"e261565","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Airway pressure release ventilation to salvage brain oxygenation in severe traumatic brain injury"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8262-8405","authenticated-orcid":false,"given":"Ryan","family":"Gensler","sequence":"first","affiliation":[{"name":"Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigmund","family":"Lilian","sequence":"additional","affiliation":[{"name":"Neurology, MedStar Georgetown University Hospital, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rory","family":"Spiegel","sequence":"additional","affiliation":[{"name":"MedStar Washington Hospital Center, Washington, DC, USA"},{"name":"Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0825-3008","authenticated-orcid":false,"given":"Jason","family":"Chang","sequence":"additional","affiliation":[{"name":"Critical Care, MedStar Washington Hospital Center, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"2025082712155154000_17.11.e261565.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2008.02.003"},{"key":"2025082712155154000_17.11.e261565.2","doi-asserted-by":"crossref","first-page":"318","DOI":"10.4103\/0970-9185.137260","article-title":"Current concepts of optimal cerebral perfusion pressure in traumatic brain injury","volume":"30","author":"Prabhakar","year":"2014","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"2025082712155154000_17.11.e261565.3","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002619"},{"key":"2025082712155154000_17.11.e261565.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000127777.16609.08"},{"key":"2025082712155154000_17.11.e261565.5","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/00003246-198705000-00002","article-title":"Airway pressure release ventilation","volume":"15","author":"Stock","year":"1987","journal-title":"Crit Care Med"},{"key":"2025082712155154000_17.11.e261565.6","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200209000-00016"},{"key":"2025082712155154000_17.11.e261565.7","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jcrc.2018.11.034","article-title":"Airway pressure release ventilation does not increase intracranial pressure in patients with traumatic brain injury with poor lung compliance","volume":"50","author":"Edgerton","year":"2019","journal-title":"J Crit Care"},{"key":"2025082712155154000_17.11.e261565.8","doi-asserted-by":"publisher","DOI":"10.1186\/cc1027"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261565","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:15:59Z","timestamp":1756322159000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261565"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":8,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,7]]},"published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1136\/bcr-2024-261565"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261565","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,11]]}}}