Effect of Intrathoracic Pressure Regulation on Decreased Cerebral Perfusion (4hour)
Physiological Effects of Intrathoracic Pressure Regulation in Patients With Decreased Cerebral Perfusion Due to Brain Injury or Intracranial Pathology (4 Hour Use)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Texas
-
San Antonio, Texas, United States, 78229
- University of Texas Health Science Center at San Antonio
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- ≥18 years of age
- intubated and mechanically ventilated on a volume controlled mode
- head injury or other intracranial pathology and compromised cerebral perfusion
- arterial line in place or alternative with continuous pressure monitoring
- SpO2 ≥90%
- mean arterial pressure >55
- admission to ICU or about to undergo neurosurgery with planned placement of an invasive intracranial pressure monitor
- inclusion presents no significant delays to planned emergent neurosurgery
- prior written informed consent
Exclusion Criteria:
- cardiac or pulmonary injury
- confirmed pneumothorax or hemothorax
- serious neck injury resulting in neck swelling with jugular venous compression
- evidence of ongoing uncontrolled bleeding
- respiratory disease such as COPD, interstitial lung disease, or other parenchymal or pulmonary vascular disease
- marked hypertension at time of device use defined as systolic blood pressure >180 mmHg
- congestive heart failure
- women with positive serum or urine pregnancy test or breast feeding
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: ITPR
Use of the ITPR for 240 minutes.
|
Single use noninvasive device that is connected to a vacuum source and a means to deliver a positive pressure breath.
The device generates negative pressure during the expiratory phase, thus creating subatmospheric intrathoracic pressure between the periods of positive pressure ventilations.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cerebral Perfusion Pressure (CPP)
Time Frame: During 240 minutes of device use
|
Change from baseline CPP compared with the CPP during use of the ITPR.
|
During 240 minutes of device use
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mean Arterial Pressure (MAP)
Time Frame: baseline to end of ITPR use
|
Change from baseline MAP compared with the MAP during use of the ITPR.
|
baseline to end of ITPR use
|
|
Intracranial Pressure (ICP)
Time Frame: baseline to end of ITPR use
|
Change from baseline ICP compared with the ICP during use of the ITPR.
|
baseline to end of ITPR use
|
|
End-tidal Carbon Dioxide (EtCO2)
Time Frame: baseline to end of ITPR use
|
Change from baseline EtCO2 compared with the EtCO2 during use of the ITPR.
|
baseline to end of ITPR use
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- ACSI 450-0003
- W81XWH-12-C-0181 (Other Grant/Funding Number: United States Army Institute for Surgical Research)
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