{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T07:38:50Z","timestamp":1774424330687,"version":"3.50.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007137","name":"Helse Nord RHF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007137","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Positive end-expiratory pressure (PEEP) and prone positioning are key components in the management of acute respiratory distress syndrome (ARDS), improving gas exchange and protecting the lung via enhanced lung recruitment and homogenization of lung aeration. However, higher intrathoracic pressures may increase intracranial pressure (ICP) or impair cerebral autoregulation, as reflected by vascular reactivity. This study investigated whether stepwise PEEP elevations affect ICP, the pressure reactivity index (PRx), and brain tissue oxygenation (PbO2) in a porcine ARDS model, comparing prone and supine positions, and whether baseline physiological variables modify the ICP response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twelve anesthetized pigs with bronchial lavage\u2013induced ARDS were studied in a randomized crossover design with stepwise PEEP increases (5, 10, 15, and 20 cmH2O) in prone and supine positions while maintaining stable arterial carbon dioxide tension and cerebral perfusion pressure. Intracranial pressure, PRx, and PbO2 were continuously monitored, and effects of PEEP and position were analyzed using linear mixed-effects models and analysis of variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Increasing PEEP was associated with a progressive rise in ICP, whereas PRx remained unchanged across PEEP levels and body positions. PbO2 showed a non-significant upward trend with increasing PEEP, while the PbO2\/PaO2 ratio remained stable. Higher baseline pulmonary artery pressure was associated with larger ICP increases, whereas higher baseline respiratory rate was associated with attenuated responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this porcine ARDS model, moderate PEEP escalation resulted in a modest increase in ICP without impairment of cerebrovascular reactivity, with similar effects in prone and supine positions, suggesting that lung protective ventilation strategies may be compatible with stable intracranial physiology when arterial carbon dioxide tension and cerebral perfusion pressure are controlled.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2026.1792273","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T05:54:06Z","timestamp":1774418046000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Positive end-expiratory pressure increases intracranial pressure but does not affect PRx, regardless of body position, in a porcine ARDS model"],"prefix":"10.3389","volume":"17","author":[{"given":"R\u00f8nnaug","family":"Hammervold","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Nordland Hospital Trust","place":["Bod\u00f8, Norway"]},{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Faculty of Health Sciences","place":["Troms\u00f8, Norway"]},{"name":"Research Laboratory, Nordland Hospital Trust","place":["Bod\u00f8, Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erta","family":"Beqiri","sequence":"additional","affiliation":[{"name":"Brain Physics Laboratory, Department of Clinical Neurosciences, University of Cambridge","place":["Cambridge, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Smielewski","sequence":"additional","affiliation":[{"name":"Brain Physics Laboratory, Department of Clinical Neurosciences, University of Cambridge","place":["Cambridge, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin S.","family":"Storm","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Nordland Hospital Trust","place":["Bod\u00f8, Norway"]},{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Faculty of Health Sciences","place":["Troms\u00f8, Norway"]},{"name":"Research Laboratory, Nordland Hospital Trust","place":["Bod\u00f8, Norway"]},{"name":"Nord University, Faculty of Nursing and Health Sciences","place":["Bod\u00f8, Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik W.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Nordland Hospital Trust","place":["Bod\u00f8, Norway"]},{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Faculty of Health Sciences","place":["Troms\u00f8, Norway"]},{"name":"Research Laboratory, Nordland Hospital Trust","place":["Bod\u00f8, Norway"]},{"name":"Nord University, Faculty of Nursing and Health Sciences","place":["Bod\u00f8, Norway"]},{"name":"University of Oslo, Faculty of Medicine, Institute of Clinical Medicine","place":["Oslo, Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claude","family":"Gu\u00e9rin","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lyon, Facult\u00e9 de m\u00e9decine Lyon-Est","place":["Lyon, France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirin K.","family":"Frisvold","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Faculty of Health Sciences","place":["Troms\u00f8, Norway"]},{"name":"Department of Anaesthesia and Intensive Care, University Hospital of North Norway","place":["Troms\u00f8, Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1097\/00000542-197609000-00004","article-title":"Intracranial responses to PEEP","volume":"45","author":"Aidinis","year":"1976","journal-title":"Anesthesiology"},{"key":"B2","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1164\/rccm.201312-2193CI","article-title":"The application of esophageal pressure measurement in patients with respiratory failure","volume":"189","author":"Akoumianaki","year":"2014","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1186\/s13054-023-04509-3","article-title":"Mechanical ventilation in patients with acute brain injury: a systematic review with meta-analysis","volume":"27","author":"Asehnoune","year":"2023","journal-title":"Crit. Care"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-024-04950-y","article-title":"Transpulmonary pressure monitoring in critically ill patients: pros and cons","volume":"28","author":"Ball","year":"2024","journal-title":"Crit. Care"},{"key":"B5","first-page":"788","article-title":"A simple method for assessing the validity of the esophageal balloon technique","volume":"126","author":"Baydur","year":"1982","journal-title":"Am. Rev. Respir. Dis."},{"key":"B6","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s40635-025-00750-y","article-title":"Intracranial response to positive end-expiratory pressure is influenced by lung recruitability and gas distribution during mechanical ventilation in acute brain injury patients: a proof-of-concept physiological study","volume":"13","author":"Bencze","year":"2025","journal-title":"Intensive Care Med. Exp."},{"key":"B7","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1186\/s13054-023-04383-z","article-title":"Neurological and respiratory effects of lung protective ventilation in acute brain injury patients without lung injury: brain vent, a single centre randomized interventional study","volume":"27","author":"Beqiri","year":"2023","journal-title":"Crit. Care"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjopen-2021-060188","article-title":"Brain Oxygen Optimization in Severe Traumatic Brain Injury (BOOST-3): a multicentre, randomised, blinded-endpoint, comparative effectiveness study of brain tissue oxygen and intracranial pressure monitoring versus intracranial pressure alone","volume":"12","author":"Bernard","year":"2022","journal-title":"BMJ Open"},{"key":"B9","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1007\/s12028-016-0328-9","article-title":"The effect of positive end-expiratory pressure on intracranial pressure and cerebral hemodynamics","volume":"26","author":"Boone","year":"2017","journal-title":"Neurocrit Care"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1080\/17476348.2017.1235976","article-title":"Mechanical ventilation in neurocritical patients: A systematic literature review","volume":"10","author":"Borsellino","year":"2016","journal-title":"Expert Rev. Respir. Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/jcm10122738","article-title":"Patient-self inflicted lung injury: A practical review","volume":"10","author":"Carteaux","year":"2021","journal-title":"J. Clin. Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1177\/1751143720980273","article-title":"Multimodal brain monitoring following traumatic brain injury: a primer for intensive care practitioners","volume":"23","author":"Casault","year":"2022","journal-title":"J. Intensive Care Soc."},{"key":"B13","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1186\/s12883-018-1191-4","article-title":"Intracranial pressure responsiveness to positive end-expiratory pressure in different respiratory mechanics: a preliminary experimental study in pigs","volume":"18","author":"Chen","year":"2018","journal-title":"BMC Neurol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s12868-021-00674-9","article-title":"Effect of increased positive end-expiratory pressure on intracranial pressure and cerebral oxygenation: impact of respiratory mechanics and hypovolemia","volume":"22","author":"Chen","year":"2021","journal-title":"BMC Neurosci."},{"key":"B15","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1007\/s00134-019-05900-x","article-title":"A management algorithm for adult patients with both brain oxygen and intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC)","volume":"46","author":"Chesnut","year":"2020","journal-title":"Intensive Care Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1164\/rccm.200710-1589OC","article-title":"Lung stress and strain during mechanical ventilation for acute respiratory distress syndrome","volume":"178","author":"Chiumello","year":"2008","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1164\/ajrccm.164.1.2007011","article-title":"Recruitment and derecruitment during acute respiratory failure: A clinical study","volume":"164","author":"Crotti","year":"2001","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1097\/TA.0000000000000518","article-title":"Lung protective ventilation (ARDSNet) versus airway pressure release ventilation: Ventilatory management in a combined model of acute lung and brain injury","volume":"78","author":"Davies","year":"2015","journal-title":"J. Trauma Acute Care Surg."},{"key":"B19","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1164\/ajrccm.157.1.9604014","article-title":"Ventilator-induced lung injury: lessons from the experimental studies","volume":"157","author":"Dreyfuss","year":"1998","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1097\/ALN.0000000000004875","article-title":"Feasibility of prone positioning for brain-injured patients with severe acute respiratory distress syndrome: A systematic review and pilot study (ProBrain)","volume":"140","author":"Elmaleh","year":"2024","journal-title":"Anesthesiology"},{"key":"B21","doi-asserted-by":"publisher","first-page":"399","DOI":"10.18093\/0869-0189-2018-28-4-399-410","article-title":"Mechanical ventilation in adults with acute respiratory distress syndrome: an official clinical guideline of American Thoracic Society\/European Society of Intensive Care Medicine\/Society of Critical Care Medicine","volume":"28","author":"Fan","year":"2018","journal-title":"Russ Pulmonol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1007\/s00134-015-4200-8","article-title":"The \u201cbaby lung\u201d became an adult","volume":"42","author":"Gattinoni","year":"2016","journal-title":"Intensive Care Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1164\/rccm.201308-1532ci","article-title":"Prone position in acute respiratory distress syndrome: rationale, indications, and limits","volume":"188","author":"Gattinoni","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.1007\/s00134-016-4505-2","article-title":"Ventilator-related causes of lung injury: the mechanical power","volume":"42","author":"Gattinoni","year":"2016","journal-title":"Intensive Care Med."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2023.1139658","article-title":"Effects of positive end-expiratory pressure on cerebral hemodynamics in acute brain injury patients","volume":"14","author":"Giardina","year":"2023","journal-title":"Front. Physiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"2385","DOI":"10.1007\/s00134-020-06306-w","article-title":"Prone position in ARDS patients: why, when, how and for whom","volume":"46","author":"Gu\u00e9rin","year":"2020","journal-title":"Intensive Care Med."},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1501284","article-title":"Positive end-expiratory pressure increases intracranial pressure but not pressure reactivity index in supine and prone positions: a porcine model study","volume":"11","author":"Hammervold","year":"2024","journal-title":"Front. Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1007\/s00134-011-2232-2","article-title":"Acute effects of intracranial hypertension and ARDS on pulmonary and neuronal damage: A randomized experimental study in pigs","volume":"37","author":"Heuer","year":"2011","journal-title":"Intensive Care Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"311","DOI":"10.3171\/jns.2005.102.2.0311","article-title":"Pressure reactivity as a guide in the treatment of cerebral perfusion pressure in patients with brain trauma","volume":"102","author":"Howells","year":"2005","journal-title":"J. Neurosurg."},{"key":"B30","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1016\/j.ccrj.2024.05.003","article-title":"Brain tissue oxygen monitoring in moderate-to-severe traumatic brain injury: physiological determinants, clinical interventions and current randomised controlled trial evidence","volume":"26","author":"Jeffcote","year":"2024","journal-title":"Crit. Care Resusc"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.1227\/neu.0000000000003019","article-title":"The pressure reactivity index as a measure for cerebrovascular autoregulation: Validation in a porcine cranial window model","volume":"95","author":"Klein","year":"2024","journal-title":"Neurosurgery"},{"key":"B32","doi-asserted-by":"publisher","first-page":"5926","DOI":"10.1038\/s41598-020-62435-8","article-title":"Comparison of wavelet and correlation indices of cerebral autoregulation in a pediatric swine model of cardiac arrest","volume":"10","author":"Liu","year":"2020","journal-title":"Sci. Rep."},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1655813","article-title":"Organ crosstalk: brain-lung interaction","volume":"12","author":"Mascia","year":"2025","journal-title":"Front. Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1007\/s11940-022-00726-3","article-title":"Brain-lung crosstalk: management of concomitant severe acute brain injury and acute respiratory distress syndrome","volume":"24","author":"Matin","year":"2022","journal-title":"Curr. Treat Options Neurol."},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-018-0434-2","article-title":"Effects of positive end-expiratory pressure strategy in supine and prone position on lung and chest wall mechanics in acute respiratory distress syndrome","volume":"8","author":"Mezidi","year":"2018","journal-title":"Ann. Intensive Care"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.5492\/wjccm.v4.i3.163","article-title":"Brain-lung crosstalk: implications for neurocritical care patients","volume":"4","author":"Mrozek","year":"2015","journal-title":"World J. Crit. Care Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1007\/s12028-023-01860-9","article-title":"Inaugural state of the union: continuous cerebral autoregulation monitoring in the clinical practice of neurocritical care and anesthesia","volume":"40","author":"Park","year":"2024","journal-title":"Neurocrit Care"},{"key":"B38","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1164\/rccm.202311-2011ST","article-title":"An update on management of adult patients with acute respiratory distress syndrome: an official american thoracic society clinical practice guideline","volume":"209","author":"Qadir","year":"2024","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B39","article-title":"R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing","year":"2021"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00771","article-title":"Lung injury is a predictor of cerebral hypoxia and mortality in traumatic brain injury","volume":"11","author":"Robba","year":"2020","journal-title":"Front. Neurol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1097\/ANA.0000000000000295","article-title":"Effects of prone position and positive end-expiratory pressure on noninvasive estimators of ICP: A pilot study","volume":"29","author":"Robba","year":"2017","journal-title":"J. Neurosurg. Anesthesiol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"2397","DOI":"10.1007\/s00134-020-06283-0","article-title":"Mechanical ventilation in patients with acute brain injury: recommendations of the European Society of Intensive Care Medicine consensus","volume":"46","author":"Robba","year":"2020","journal-title":"Intensive Care Med."},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3791\/62327","article-title":"Surfactant depletion combined with injurious ventilation results in a reproducible model of the acute respiratory distress syndrome (ARDS)","volume":"2021","author":"Russ","year":"2021","journal-title":"J. Vis. Exp."},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.3791\/53610","article-title":"Lavage-induced surfactant depletion in pigs as a model of the acute respiratory distress syndrome (ARDS)","volume":"2016","author":"Russ","year":"2016","journal-title":"J. Vis. Exp."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1164\/rccm.202009-3539OC","article-title":"Effect of esophageal pressure\u2013guided positive end-expiratory pressure on survival from acute respiratory distress syndrome: A risk-based and mechanistic reanalysis of the EPVent-2 trial","volume":"204","author":"Sarge","year":"2021","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1016\/j.bas.2024.102835","article-title":"Advanced neuromonitoring powered by ICM+ and its place in the Brand New AI World, reflections at the 20th anniversary boundary","volume":"4","author":"Smielewski","year":"2024","journal-title":"Brain Spine"},{"key":"B47","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1159\/000528914","article-title":"European consensus guidelines on the management of respiratory distress syndrome: 2022 update","volume":"120","author":"Sweet","year":"2023","journal-title":"Neonatology"},{"key":"B48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/biomedicines10040923","article-title":"Effects of reversal of hypotension on cerebral microcirculation and metabolism in experimental sepsis","volume":"10","author":"Taccone","year":"2022","journal-title":"Biomedicines"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-025-03116-9","article-title":"Effect of prone position on cerebral hemodynamics and noninvasive intracranial pressure assessed using transcranial Doppler in patients undergoing spine surgeries: a prospective observational study","volume":"25","author":"Taj","year":"2025","journal-title":"BMC Anesthesiol"},{"key":"B50","doi-asserted-by":"publisher","first-page":"2095","DOI":"10.1056\/NEJMoa0708638","article-title":"Mechanical ventilation guided by esophageal pressure in acute lung injury","volume":"359","author":"Talmor","year":"2008","journal-title":"N Engl. J. Med."},{"key":"B51","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1007\/s12028-022-01593-1","article-title":"Mechanical ventilation in patients with traumatic brain injury: is it so different","volume":"38","author":"Taran","year":"2023","journal-title":"Neurocrit Care"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1617","DOI":"10.1152\/japplphysiol.00251.2020","article-title":"Comparison of pleural and esophageal pressure in supine and prone positions in a porcine model of acute respiratory distress syndrome","volume":"128","author":"Terzi","year":"2020","journal-title":"J. Appl. Physiol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/j.ccrj.2023.10.009","article-title":"The pressure reactivity index as a measure of cerebral autoregulation and its application in traumatic brain injury management","volume":"25","author":"Tsigaras","year":"2023","journal-title":"Crit. Care Resusc"},{"key":"B54","doi-asserted-by":"publisher","first-page":"E269","DOI":"10.1097\/CCM.0000000000004820","article-title":"Prone position ventilation in neurologically ill patients: A systematic review and proposed protocol","volume":"49","author":"Wright","year":"2021","journal-title":"Crit. Care Med."},{"key":"B55","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1177\/09287329241291322","article-title":"Preliminary study: Low to moderate PEEP effects on ICP in acute neurological injury patients under mechanical ventilation","volume":"33","author":"Xiu","year":"2025","journal-title":"Technol. Health Care"},{"key":"B56","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1164\/rccm.201709-1806OC","article-title":"Esophageal manometry and regional transpulmonary pressure in lung injury","volume":"197","author":"Yoshida","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1649074","article-title":"Experimental animal models of acute respiratory distress syndrome: one-hit and two-hit establishment application","volume":"16","author":"Zhao","year":"2025","journal-title":"Front. Immunol."},{"key":"B58","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40001-022-00780-2","article-title":"ARDS associated acute brain injury: from the lung to the brain","volume":"27","author":"Ziaka","year":"2022","journal-title":"Eur. J. Med. Res."},{"key":"B59","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.jointm.2023.08.001","article-title":"Effects of positive end-expiratory pressure on intracranial pressure, cerebral perfusion pressure, and brain oxygenation in acute brain injury: Friend or foe? A scoping review","volume":"4","author":"Zunino","year":"2024","journal-title":"J. Intensive Med."},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.3171\/FOC.2008.25.10.E2","article-title":"Continuous monitoring of cerebrovascular pressure reactivity in patients with head injury","volume":"25","author":"Zweifel","year":"2008","journal-title":"Neurosurg. Focus"}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2026.1792273\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T05:54:07Z","timestamp":1774418047000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2026.1792273\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":60,"alternative-id":["10.3389\/fphys.2026.1792273"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2026.1792273","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"article-number":"1792273"}}