Ventilator-associated pneumonia (VAP) is a common infection in critically ill patients,especially those with acute brain injuries, leading to increased mortality and longer ICUstays.The mechanical insufflation/exsufflation (M-I/E) cough assist device improves outcomes inpatients with neuromuscular disorders but its effects on brain-injured patients arelargely unknown.This study is conducted at a tertiary neurosurgical medical center and consists of twosubstudies. The prospective physiological study assessed the impact of M-I/E onhemodynamics and ICP in mechanically ventilated neurosurgical patients. The combinedretrospective-prospective clinical study was performed to investigate the efficacy ofM-I/E on occurence of VAP and other clinical outcomes.
Not Provided
Inclusion Criteria:
- Post-neurosurgical adult patients
- >18years old
- Body mass index (BMI) <35kg/m2)
- Receiving mechanical ventilation
- With arterial blood catheter for continuous pressure measurement and/or ventricular
catheter drainage for ICP measurement (only for study one)
Exclusion Criteria:
- ICP > 22cmH2O or evidence of increased ICP
- Hemodynamically unstable (SBP< 90 or > 160 mmHg; DBP < 50 or > 110 mmHg, using
cardiovascular medicine to maintain pressure, or known cardiac failure)
- Patients with lung trauma, emphysema, bronchopleural fistula or risk of pneumothorax
- History of mechanical ventilation and pneumonia within 6 months before ICU admission
Beijing Sanbo Brain Hospital, Capital Medical University
Beijing 1816670, Beijing Municipality 2038349, China
Zhonghua Shi, PhD,MD, Principal Investigator
Capital Medical University