Ventilator-associated pneumonia (VAP) is a common infection in critically ill patients, especially those with acute brain injuries, leading to increased mortality and longer ICU stays. The mechanical insufflation/exsufflation (M-I/E) cough assist device improves outcomes in patients with neuromuscular disorders but its effects on brain-injured patients are largely unknown. This study is conducted at a tertiary neurosurgical medical center and consists of two substudies. The prospective physiological study assessed the impact of M-I/E on hemodynamics and ICP in mechanically ventilated neurosurgical patients. The combined retrospective-prospective clinical study was performed to investigate the efficacy of M-I/E on occurence of VAP and other clinical outcomes.
Study Type
OBSERVATIONAL
Enrollment
210
Beijing Sanbo Brain Hospital, Capital Medical University
Beijing, Beijing Municipality, China
Mean blood pressure
In study one, mean blood pressure will be recorded during the incremental pressure changes in the study one
Time frame: during the process of physiological study, up to 2 hours
Heart rate
In study one, heart rate will be recorded during the incremental pressure changes in the study one
Time frame: During the process of physiological study, up to 2 hours
Rate of ventilator associated pneumonia
In study two, ventilator associated pneumonia is defined as pneumonia occurring in patients who have been mechanically ventilated for at least 48 hours. Pneumonia was diagnosed by clinical features (e.g., cough, fever, pleuritic chest pain) and by lung imaging. To derived the diagnosis of pneumonia, patient electronical record, lab results, and images were extracted from the electronical system.
Time frame: Within 7 days after the onset of mechanical of ventilation
Intracranial pressure
In study one, intracranial pressure will be recorded during the incremental pressure changes in the study one
Time frame: During the process of physiological study, up to 2 hours
Length of stay in ICU
Days of ICU Stay
Time frame: Patients will be followed up until 28 days after surgery, discharged from hospital or dead, which ever came first,through study completion, an average of 1 year
Length of hospital stay
Days of hospital stay
Time frame: Patients will be followed up until 28 days after surgery, discharged from hospital or dead, which ever came firstthrough study completion, an average of 1 year
Days of receiving mechanical ventilation
The duration from the start of mechanical ventilation to the weaning off from ventilator
Time frame: Patients will be followed up until 28 days after surgery, discharged from hospital or dead, which ever came firstthrough study completion, an average of 1 year
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