Received: June 1, 2026
Accepted for publication: July 28, 2026
Published online: September 30, 2026
UDC: 616.8-002.5:615.816.2
DOI: 10.26212/2227-1937.2026.18.93.002
MECHANICAL VENTILATION IN THE COMPREHENSIVE TREATMENT OF TUBERCULOSIS PATIENTS WITH CENTRAL NERVOUS SYSTEM INVOLVEMENT AND VENTILATOR-ASSOCIATED CONDITIONS
Abdukarimov Kh.Kh., Arymbayeva A.B., Nuralbayeva P.K.
Kazakh-Russian Medical University, National Scientific Center of Phthisiopulmonology of the Ministry of Health of the Republic of Kazakhstan, Almaty
Introduction. Mechanical ventilation (MV) is a critical component of intensive care for patients with central nervous system lesions. The distinctive features of MV in this pathology include a high proportion of invasive MV, as well as its prolonged nature. It is well known that prolonged MV is associated with the occurrence of both pulmonary and extrapulmonary life-threatening complications. Among infectious pulmonary complications, ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT) are most frequently identified.
Objective. To evaluate the efficacy of intensive care methods, including mechanical ventilation, in the comprehensive management of tuberculosis patients with central nervous system involvement.
Materials and Methods. The study presents data on 31 patients with tuberculosis of the meninges and central nervous system whose comprehensive treatment included mechanical ventilation (MV). The analysis covers their age distribution, sex, concomitant specific pulmonary and extrapulmonary lesions, and level of consciousness upon admission. Data on the duration of mechanical ventilation are also provided (the total duration for this cohort was 673 days, with an average of 21 days per patient).
Results. To compare the outcomes of comprehensive treatment associated with invasive MV, patients were divided into 3 groups according to the clinical classification of ventilator-associated events.
Group 1, consisting of two patients who received MV for 1 to 5 days, showed a 0% mortality rate.
Group 2, consisting of 11 patients with ventilator-associated tracheobronchitis, demonstrated a mortality rate of 63.6%.
Group 3, consisting of 18 patients with ventilator-associated pneumonia, demonstrated a mortality rate of 94.4%.
Discussion. The study determined that such a high mortality rate is driven by polyetiological factors, the primary ones being: late detection of most patients (for instance, out of 31 patients, 19 were admitted with altered consciousness, including 5 in stupor or somnolence, and 14 in a comatose state), and the presence of 50 specific pulmonary and extrapulmonary lesions among the 31 patients with meningeal and central nervous system involvement.
Conclusion. Medical innovations continue to advance; currently, endotracheal and tracheostomy tubes with a dedicated lumen for subglottic secretion drainage, as well as devices for continuous cuff pressure monitoring of endotracheal and tracheostomy tubes, are available.
Keywords: mechanical ventilation, central nervous system tuberculosis, ventilator-associated events.
