An interventional study of PEEP at 5cmH2O and PEEP at 10cmH2O in Traumatic Brain Injury and Mechanical Ventilation Complication, sponsored by Hongpeng Li. Completed. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2017-10-02.
Sponsored by Hongpeng Li · Not applicable, Interventional, and Other
The impact of PEEP on ICP was dependent on the difference between elevated CVP levels and baseline ICP levels. ICP would increase once elevated CVP through PEEP adjustment exceeds the baseline ICP.
all patients were exposed to incremental PEEP levels of 0, 5, 10, and 15cmH2O with 100% of FiO2. The measurements were done bedside on stabilized hemodynamics and intracranial pressure. The measurement was discontinued if the following situation presented and remedies were applied accordingly: (1) CPP \< 60 mmHg (norepinephrine at 0.3\~1.0μg/kg.min was used); (2) ICP > 25 mmHg (PEEP was restored to 0); (3) increase of pressure plateau > 35 cmH2O (tidal volume was decreased and PetCO2 was maintained at 30\~35mmHg); (4) SpO2 \< 90% (PEEP was restored to 0); and (5) suspicion of pneumothorax (PEEP was restored to 0 and chest radiography was performed). An equilibration period (at least 90 seconds) was entailed to ensure a normalized baseline PetCO2 through modulating tidal volume and respiratory rate.
ICP, CVP, Pj, and MAP were measured twice or more at each level of PEEP for consecutively five days after admission. CPP was calculated according to the following equation: CPP=MAP-ICP. The difference between baseline ICP and CVP was categorized into the following three groups according to the previous findings: Group I,IVPD ≤ 3mmHg, Group II, 3 \< IVPD ≤ 6 mmHg, Group III, IVPD > 6 mmHg. Relationships between PEEP and ICP, CVP and MAP, CVP and Pj were analyzed in each group respectively.
Exclusion Criteria:
Effect of PEEP at 5cmH2O on ICP in Group I:IVPD≤3mmHg Effect of PEEP at 10cmH2O on ICP in Group I:IVPD≤3mmHg Effect of PEEP at 15cmH2O on ICP in Group I:IVPD≤3mmHg
Other: PEEP at 5cmH2O · Other: PEEP at 10cmH2O · Other: PEEP at 15cmH2O
Effect of PEEP at 5cmH2O on ICP in Group II:3mmHg\<IVPD≤6mmHg Effect of PEEP at 10cmH2O on ICP in Group II:3mmHg\<IVPD≤6mmHg Effect of PEEP at 15cmH2O on ICP in Group II:3mmHg\<IVPD≤6mmHg
Other: PEEP at 5cmH2O · Other: PEEP at 10cmH2O · Other: PEEP at 15cmH2O
Effect of PEEP at 5cmH2O on ICP in Group III:IVPD\>6mmHg Effect of PEEP at 10cmH2O on ICP in Group III:IVPD\>6mmHg Effect of PEEP at 15cmH2O on ICP in Group III:IVPD\>6mmHg
Other: PEEP at 5cmH2O · Other: PEEP at 10cmH2O · Other: PEEP at 15cmH2O
Effect of PEEP at 5cmH2O on ICP
Effect of PEEP at 10cmH2O on ICP
Effect of PEEP at 15cmH2O on ICP
Effects of positive end-expiratory pressure on intracranial pressure in patients with severe traumatic brain injury
The impact of PEEP on ICP was dependent on the difference between elevated CVP levels and baseline ICP levels. ICP would increase once elevated CVP through PEEP adjustment exceeds the baseline ICP.
Time frame: up to 12 months
No study locations are listed for this record.
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This study is completed, as verified in Sep 2017. You cannot join it, but the record below documents what was studied.
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