Mechanical Ventilation in Severe Brain Injury: The Effect of Positive End Expiratory Pressure on Intracranial Pressure

Beth Israel Lahey Health

Status: Terminated

Conditions: Brain Injuries; Respiratory Failure; Lung Injury; Positive-Pressure Respiration, Intrinsic; Critical Illness; Intracranial Hypertension

Treatments: Other: PEEP titrated mechanical ventilation

Study type: Interventional

Funder types: Other

Identifiers

NCT02680704

2015P000089

Details and patient eligibility

About

The purpose of this study is to collect physiologic data from patients with severe brain injury who require mechanical ventilation in order to describe the impact of ventilation, specifically positive end expiratory pressure (PEEP), on intracranial pressure (ICP).

Enrollment: 4 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with severe brain injury (GCS 8 or less)
• Receiving mechanical ventilation
• Receiving intracranial pressure monitoring

Exclusion criteria

• Esophageal varices
• Esophageal trauma
• Recent esophageal surgery
• Coagulopathy (Platelets < 80k or INR> 2 )
• Other contraindication for esophageal manometry
• Already receiving PEEP > 15 cmH2O at enrollment
• Intracranial hypertension (defined as ICP > 20 mmHg)
• Decompressive hemi-craniectomy

Trial design

Primary purpose: Other

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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4 participants in 1 patient group

PEEP Titration Arm

Other group

Description:

PEEP titrated mechanical ventilation

Treatment:

Other: PEEP titrated mechanical ventilation