[Mechanical ventilation]

The central goal in the management of a patient with acute encephalopathy and encephalitis is the prevention of hypoxemic of hypoxic secondary insults. It is recommended that partial pressure of arterial oxygen should be more than 80 mmHg with mechanical ventilation and supplemental oxygen. About carbon dioxide tension, it is standard practice to ventilate to normocapnia instead of routine setting of hypocapnia. Hyperventilation therapy is limited to specialized conditions with intracranial hypertension which is refractory to other therapy and induces neurological deteriorations. And it is presumed that increasing positive end-expiratory pressure could be related to increase intracranial pressure and decrease cerebral perfusion pressure in these patients especially with low blood pressure. To avoid unfavorable sequelae in brain, lung, and all other organs, we consider that under multimodal brain monitoring, ventilator setting should be decided on a case-by-case basis.