Clinical research evaluating mechanical ventilation liberation in patients with acute brain injury (ABI) shows substantial outcome heterogeneity, limiting evidence synthesis. We aimed to develop an internationally endorsed core outcome set (COS) and a hierarchical composite endpoint for ventilation trials in neurocritical care. Following COS-STAD/COS-STAP standards, we conducted a 4-round international Delphi study. Candidate outcomes were identified via a scoping review. A multidisciplinary panel from 31 countries scored outcomes using a 9-point GRADE scale. Inclusion required >70
