![]() Lack of targeted treatment for underlying cardiorespiratory dysfunction, including VIDD, likely contributes to physical activity intolerance and poor functional outcomes in these patients. Thus, cardiopulmonary exercise testing should be routinely performed in this patient population and those with cardiorespiratory deficits should be further evaluated for diaphragmatic dysfunction. Synthesis of data from other patient populations reveals that cardiorespiratory dysfunction is likely a consequence of ventilator-induced diaphragmatic dysfunction (VIDD), which is not currently addressed in TBI management. The literature reveals patients who have survived moderate-to-severe TBI have ~ 25–35% reduction in maximal aerobic capacity 6–18 months post-injury, resting pulmonary capacity parameters that are reduced 25–40% for weeks to years post-injury, increased sedentary behavior, and elevated risk of cardiorespiratory-related morbidity and mortality. This narrative review was developed through systematic and non-systematic searches for research relating cardiorespiratory function to moderate-to-severe TBI. Persistent cardiorespiratory dysfunction is a potentially modifiable yet often overlooked major contributor to the alarmingly high long-term morbidity and mortality rates in these patients. Survivors face significant long-term functional limitations, including physical activity intolerance and disordered sleep. Moderate-to-severe traumatic brain injury (TBI) is a chronic health condition with multi-systemic effects.
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