An interventional study of Lung Protective Ventilation in Acute Brain Injury, Traumatic Brain Injury and Intracerebral Hemorrhage, sponsored by Colin Grissom. Active, not recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-08.
Sponsored by Colin Grissom · Not applicable, Interventional, and Treatment
Patients who experience lung injury are often placed on a ventilator to help them heal; however, if the ventilator volume settings are too high, it can cause additional lung injury. It is proven that using lower ventilator volume settings improves outcomes. In patients with acute brain injury, it is proven that maintaining a normal partial pressure of carbon dioxide in the arterial blood improves outcomes. Mechanical ventilator settings with higher volumes and higher breathing rates are sometimes required to maintain a normal partial pressure of carbon dioxide. These 2 goals of mechanical ventilation, using lower volumes to prevent additional lung injury but maintaining a normal partial pressure of carbon dioxide, are both important for patients with acute brain injury. The investigators have designed a computerized ventilator protocol in iCentra that matches the current standard of care for mechanical ventilation of patients with acute brain injury by targeting a normal partial pressure of carbon dioxide with the lowest ventilator volume required.
This is a quality improvement study with the purpose of observing and measuring the effects of implementation of a standard of care mechanical ventilation protocol for patients with acute brain injury in the iCentra electronic medical record system at Intermountain Medical Center. We hypothesize that implementation of a standardized neuro lung protective ventilation protocol will be feasible, will achieve a target normal partial pressure of carbon dioxide, will decrease tidal volumes toward the target 6 mL/kg predicted body weight, and will improve outcomes.
Exclusion Criteria:
Subjects with acute brain injury (traumatic brain injury and non-traumatic brain injury) will receive neuro lung protective ventilation which targets a normal arterial partial pressure of carbon dioxide with the lowest tidal volume possible (6 to 8 ml/kg predicted body weight). Protocols for oxygenation and weaning from the ventilator will also be followed.
Procedure: Lung Protective Ventilation
Neuro lung protective ventilation for patients with acute brain injury is designed to target a normal partial pressure of arterial carbon dioxide and decrease initial tidal volumes toward a target 6 ml/kg predicted body weight PBW (range 6 to 8 ml/kg PBW)
Patient-Level Proportion of time on Mechanical Ventilation with a Tidal Volume <= 6.5 ml/kg PBW
Time frame: Time of initiation of mechanical ventilation to time of cessation of mechanical ventilation, an average of 5 days
Proportion of time with a target PaCO2 of 35 to 45 mm Hg
Time frame: Time of initiation of mechanical ventilation to time of cessation of mechanical ventilation, an average of 5 days
Average number of protocol deviations for all subjects (protocol compliance)
Average of the number of instances in which the procedures specified in the protocol were not followed for each enrolled subject
Time frame: Time of initiation of mechanical ventilation to time of cessation of mechanical ventilation, an average of 5 days
Hospital Discharge Disposition
Routine, skilled nursing facility, home health, other
Time frame: Day of hospital discharge, an average of 10 days after admission
Hospital, 28-Day, and 90-Day Mortality
Time frame: Hospital admission through 90 days
Ventilator-free days to day 28
Time frame: Initiation of mechanical ventilation to day 28
Time to First ICU Activity
Time frame: Day of admission to day of first ICU activity, an average of 0.2 days
Hospital, ICU Length of Stay
Time frame: Day of admission to day of discharge, an average of 10 days
Health Care Utilization
Number of procedures/surgeries while in the hospital and number of days of hospitalization
Time frame: Day of admission to day of discharge, an average of 10 days
Quality of Life - up to 1 year after day of discharge
May include SF-36 or similar measures
Time frame: Day of admission until up to 1 year after day of discharge
Costs of Care
Time frame: Day of admission to day of discharge, an average of 10 days
Documents are hosted by the registry — open the source record to download them.
Plan to share: No — The intent of the investigators is to publish their experience with implementation of this protocol in the peer reviewed medical literature.
This study is active, not recruiting, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.
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