Introduction neurocritical care ncc patients often require prolonged mechanical ventilation and they are at high risk of respiratory complications therefore the potential benefit role of protective lung ventilation plv which demonstrated to reduce postoperative complications in patients with acute distress respiratory syndrome has been suggested even on ncc patients however plv can increase intracranial pressure as result of permissive hypercapnia and of high airway pressures . Neuropatients often require invasive mechanical ventilation mv ideal ventilator settings and respiratory targets in neuro patients are unclear current knowledge suggests maintaining protective tidal volumes of 6 8 ml kg of predicted body weight in neuropatients this approach may reduce the rate of pulmonary complications although it cannot be easily applied in a neuro setting due to the need for special care to minimize the risk of secondary brain damage additionally the . Introduction neurocritical care ncc patients often require prolonged mechanical ventilation and they are at high risk of respiratory complications therefore the potential benefit role of protective lung ventilation plv which demonstrated to reduce postoperative complications in patients with acute distress respiratory syndrome has been suggested even on ncc patients however plv can increase intracranial pressure as result of permissive hypercapnia and of high airway . Neuropatients often require invasive mechanical ventilation mv ideal ventilator settings and respiratory targets in neuro patients are unclear current knowledge suggests maintaining protective tidal volumes of 6 8 ml kg of predicted body weight in neuropatients this approach may reduce the rate of pulmonary complications although it cannot be easily applied in a neuro setting due to the need for special care to minimize the risk of secondary brain damage additionally the weaning