The Neurological and Hemodynamics Safety of an Airway Clearance Technique in Patients with Acute Brain Injury: An Analysis of Intracranial Pressure Pulse Morphology Using a Non-Invasive Sensor.

Autor: Souza DA; Postgraduate Program in Internal Medicine and Health Sciences, Empresa Brasileira de Serviços Hospitalares, Universidade Federal do Paraná, Curitiba 80060-900, Brazil., Devetak GF; Empresa Brasileira de Serviços Hospitalares, Universidade Federal do Paraná, Curitiba 80060-900, Brazil., Branco MW; Postgraduate Program in Internal Medicine and Health Sciences, Universidade Federal do Paraná, Curitiba 80060-000, Brazil., Melo RL; Postgraduate Program in Internal Medicine and Health Sciences, Empresa Brasileira de Serviços Hospitalares, Universidade Federal do Paraná, Curitiba 80060-900, Brazil., Tonial JL; Department of Medicine, Universidade Federal do Paraná, Curitiba 80060-000, Brazil., Delattre AM; Department of Prevention and Rehabilitation in Physiotherapy, Universidade Federal do Paraná, Curitiba 80060-000, Brazil., Valderramas SR; Postgraduate Program in Internal Medicine and Health Sciences, Universidade Federal do Paraná, Curitiba 80060-000, Brazil.; Department of Prevention and Rehabilitation in Physiotherapy, Universidade Federal do Paraná, Curitiba 80060-000, Brazil.
Jazyk: angličtina
Zdroj: Sensors (Basel, Switzerland) [Sensors (Basel)] 2024 Nov 02; Vol. 24 (21). Date of Electronic Publication: 2024 Nov 02.
DOI: 10.3390/s24217066
Abstrakt: Patients with acute brain injury (ACI) often require mechanical ventilation (MV) and are subject to pulmonary complications, thus justifying the use of Airway Clearance Techniques (ACTs), but their effects on intracranial pressure (ICP) are unknown. This study investigates the neurological and hemodynamics safety of an ACT called ventilator hyperinflation (VHI) in patients with ACI. This was a randomized clinical equivalence trial, which included patients aged ≥ 18 years with a clinical diagnosis of hemorrhagic stroke, with symptom onset within 48 h. The participants were randomly allocated to the Experimental Group (EG, n = 15), which underwent VHI followed by tracheal aspiration (TA), and the Control Group (CG, n = 15), which underwent TA only. Neurological safety was verified by analyzing the morphology of the ICP wave through the non-invasive B4C sensor, which detects bone deformation of the skull, resulting in a P2/P1 ratio and TTP, and hemodynamics through a multi-parameter monitor. Evaluations were recorded during five instances: T1 (baseline/pre-VHI), T2 (post-VHI and before TA), T3 (post-TA), T4 and T5 (monitoring 10 and 20 min after T3). The comparison between groups showed that there was no effect of the technique on the neurological variables with a mean P2/P1 ratio [F (4,112) = 1.871; p = 0.120; np2 = 0.063] and TTP [F (4,112) = 2.252; p = 0.068; np2 = 0.074], and for hemodynamics, heart rate [F (4,112) = 1.920; p = 0.112; np2 = 0.064] and mean arterial pressure [F(2.73, 76.57) = 0.799; p = 0.488; np2 = 0.028]. Our results showed that VHI did not pose a neurological or hemodynamics risk in neurocritical patients after ACI.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje