An observational study in Acute Brain Injuries, sponsored by Capital Medical University. Completed. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2017-03-28.
Sponsored by Capital Medical University · Observational
There are concerns that the use of positive end-expiratory pressure (PEEP) for the treatment of pulmonary complications in patients with brain injury may potentially elevate intracranial pressure (ICP), and deteriorate neurological status. It is suggested that both respiratory system compliance and ventricular compliance would contribute to the elevation of ICP when PEEP increases. In theory, PEEP may cause elevation of ICP by increasing intrathoracic pressure and diminish venous return. However, the transmission of PEEP into thoracic cavity depends on the properties of the lung and chest wall. Experimental study showed that when chest wall compliance is low, PEEP can significantly increases intrathoracic pressure; whereas low lung compliance can minimize airway pressure transmission. It is generally recognized that the lung compliance decreases in acute respiratory distress syndrome (ARDS) patients due to extensive alveolar collapse. However, it has been report that the elastance ratio (the ratio between elastance of the chest wall and the respiratory system, where elastance is the reciprocal of compliance) may vary from 0.2 to 0.8. Therefore, it is important to distinguish the compliance of the chest wall and the lung when investigating the effect of PEEP on ICP.
Because intrathoracic pressure (pleural pressure) is difficult to measure in clinical situations, esophageal pressure (Pes) is considered as a surrogate of intrathoracic pressure. In the present study, the investigators determine the effect of PEEP on intrathoracic pressure and ICP by Pes measurement.
2,113 studies on the registry are indexed under Brain Injuries; 385 are open to participants now.
This study's enrollment of 30 is below the median of 100 across 690 observational studies indexed under Brain Injuries.
Browse Brain Injuries studies →Capital Medical University is the lead sponsor of 283 studies on the registry; 92 are open to participants now.
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Severe brain injured patients with ARDS
Exclusion Criteria:
After increasing positive end-expiratory pressure (PEEP) from 5 cmH2O to 15 cmH2O, intracranial pressure (ICP) increases above the median for the study population.
Procedure: Positive end-expiratory pressure
After increasing positive end-expiratory pressure (PEEP) from 5 cmH2O to 15 cmH2O, the level of intracranial pressure (ICP) increases below the median for the study population.
Procedure: Positive end-expiratory pressure
Positive end-expiratory pressure will be applied at 5 cmH2O and 15 cmH2O
Also known as: PEEP
Change in ICP level in different PEEP levels
Time frame: Baseline ICP at PEEP of 5 cmH2O, and 15 minutes after increasing the PEEP level to 15 cmH2O
No study locations are listed for this record.
This study is completed, as verified in Jan 2017. You cannot join it, but the record below documents what was studied.
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Capital Medical University