【Abstract】 Objective To investigate the effect of early ventilation combined comprehensive nursing intervention on prognosis of patients with severe craniocerebral injury complicated with acute respiratory distress syndrome. Methods 106 patients with severe craniocerebral injury complicated with acute respiratory distress syndrome from February 2017 to February 2018 were selected as the subjects of the study. According to invasive mechanical ventilation, 106 patients were divided into timely invasive mechanical ventilation group (n= 53) and delayed invasive mechanical ventilation group (,n = 53). The timely invasive mechanical ventilation group was mechanically ventilated immediately after they were admitted to the hospital after being diagnosed with severe craniocerebral injury complicated with acute respiratory distress syndrome, supplemented by appropriate comprehensive nursing interventions. The delayed invasive mechanical ventilation group was diagnosed with severe craniocerebral injury complicated with acute respiratory distress syndrome before admission to the hospital, or for other reasons, mechanical ventilation was performed after the combination of ARDS 24h, supplemented by routine care. We compared the PaO2 ? PaCO2 , SaO2 , withdrawal time, Glasgow coma score (GCS) after mechanical ventilation 24 hours and Glasgow prognosis score (GOS) after 6 month between the two groups. Results The indicators of PaO2 and SaO2 were higher in the timely invasive ventilation group than those in the delayed invasive mechanical ventilation group, and the difference was statistically significant (P<0.05). The GCS score in the timely invasive mechanical ventilation group was higher than that of the delayed invasive mechanical ventilation group, which was statistically significant (P<0.05). The withdrawal time of patients in the timely invasive ventilation group was shorter than that of the delayed invasive mechanical ventilation group, and the difference was statistically significant (P<0.05). The results of GOS in patients with timely ventilation group were superior to that in patients with delayed mechanical ventilation group. The difference was statistically significant (P<0.05). Conclusion Active and correct comprehensive nursing interventioncombined with early ventilation in patients with severe brain injury complicated with acute respiratory distress syndrome can effectively relieve symptoms of respiratory failure, restore brain function, and reduce complications. Those have important significance to improve the clinical treatment effect, improve the prognosis and improve the life quality of patients.