TY - JOUR T1 - Oesophageal pressure-guided management of severe acute respiratory distress syndrome in a patient with intractable intracranial hypertension JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-230723 VL - 12 IS - 11 SP - e230723 AU - Danny Theodore AU - Dea Mahanes AU - Michael Leite Y1 - 2019/11/01 UR - http://casereports.bmj.com/content/12/11/e230723.abstract N2 - We present a case of a young boy who sustained a traumatic brain injury (TBI) complicated by intractable intracranial hypertension and severe acute respiratory distress syndrome (ARDS) with hypercapnia. The coexisting pulmonary pathology significantly impacted intracranial pressure management. Oesophageal pressure manometry was used to guide ventilator and airway pressure management, allowing the team to optimise ARDS care while mitigating the risk of elevated intracranial pressure. While the literature describing the use of oesophageal pressure-guided ARDS management continues to evolve, there are no reported cases demonstrating use in patients with ARDS and intractable intracranial hypertension due to TBI. ER -