The PROLABI trial tested lung-protective ventilation in acute brain injury patients, comparing low tidal volume and higher PEEP to conventional methods.
Contrary to expectations, the lung-protective strategy did not improve the composite primary outcome, and was associated with increased mortality and ventilator dependency.
The incidence of ARDS was not significantly different between groups, and neurological outcomes showed no benefit from lung-protective ventilation.
Early trial termination limits definitive conclusions, warranting larger trials to confirm safety and efficacy in this vulnerable population.
