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To describe the management of arterial partial pressure of carbon dioxide (PaCO ) in severe traumatic brain-injured (TBI) patients, and the optimal target of PaCO in patients with high intracranial pressure (ICP). Secondary analysis of CENTER-TBI, a multicentre, prospective, observational, cohort study. The primary aim was to describe current practice in PaCO management during the first week of intensive care unit (ICU) after TBI, focusing on the lowest PaCO values. We also assessed PaCO management in patients with and without ICP monitoring (ICP ),