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
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 hemod...
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2024-11-01
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| author | Daniela de Almeida Souza Gisele Francini Devetak Marina Wolff Branco Reinaldo Luz Melo Jean Lucas Tonial Ana Marcia Delattre Silvia Regina Valderramas |
| author_facet | Daniela de Almeida Souza Gisele Francini Devetak Marina Wolff Branco Reinaldo Luz Melo Jean Lucas Tonial Ana Marcia Delattre Silvia Regina Valderramas |
| author_sort | Daniela de Almeida Souza |
| collection | DOAJ |
| description | 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, <i>n</i> = 15), which underwent VHI followed by tracheal aspiration (TA), and the Control Group (CG, <i>n</i> = 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; <i>p</i> = 0.120; np2 = 0.063] and TTP [F (4,112) = 2.252; <i>p</i> = 0.068; np2 = 0.074], and for hemodynamics, heart rate [F (4,112) = 1.920; <i>p</i> = 0.112; np2 = 0.064] and mean arterial pressure [F(2.73, 76.57) = 0.799; <i>p</i> = 0.488; np2 = 0.028]. Our results showed that VHI did not pose a neurological or hemodynamics risk in neurocritical patients after ACI. |
| format | Article |
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| institution | Kabale University |
| issn | 1424-8220 |
| language | English |
| publishDate | 2024-11-01 |
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| spelling | doaj-art-f296e79e06fd4c30b3161a2e73b8d58e2024-11-08T14:42:02ZengMDPI AGSensors1424-82202024-11-012421706610.3390/s24217066The 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 SensorDaniela de Almeida Souza0Gisele Francini Devetak1Marina Wolff Branco2Reinaldo Luz Melo3Jean Lucas Tonial4Ana Marcia Delattre5Silvia Regina Valderramas6Postgraduate Program in Internal Medicine and Health Sciences, Empresa Brasileira de Serviços Hospitalares, Universidade Federal do Paraná, Curitiba 80060-900, BrazilEmpresa Brasileira de Serviços Hospitalares, Universidade Federal do Paraná, Curitiba 80060-900, BrazilPostgraduate Program in Internal Medicine and Health Sciences, Universidade Federal do Paraná, Curitiba 80060-000, BrazilPostgraduate Program in Internal Medicine and Health Sciences, Empresa Brasileira de Serviços Hospitalares, Universidade Federal do Paraná, Curitiba 80060-900, BrazilDepartment of Medicine, Universidade Federal do Paraná, Curitiba 80060-000, BrazilDepartment of Prevention and Rehabilitation in Physiotherapy, Universidade Federal do Paraná, Curitiba 80060-000, BrazilPostgraduate Program in Internal Medicine and Health Sciences, Universidade Federal do Paraná, Curitiba 80060-000, BrazilPatients 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, <i>n</i> = 15), which underwent VHI followed by tracheal aspiration (TA), and the Control Group (CG, <i>n</i> = 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; <i>p</i> = 0.120; np2 = 0.063] and TTP [F (4,112) = 2.252; <i>p</i> = 0.068; np2 = 0.074], and for hemodynamics, heart rate [F (4,112) = 1.920; <i>p</i> = 0.112; np2 = 0.064] and mean arterial pressure [F(2.73, 76.57) = 0.799; <i>p</i> = 0.488; np2 = 0.028]. Our results showed that VHI did not pose a neurological or hemodynamics risk in neurocritical patients after ACI.https://www.mdpi.com/1424-8220/24/21/7066mechanical ventilationmucociliary clearanceventilator hyperinflationICP wave morphologyintracranial complianceintracranial pressure |
| spellingShingle | Daniela de Almeida Souza Gisele Francini Devetak Marina Wolff Branco Reinaldo Luz Melo Jean Lucas Tonial Ana Marcia Delattre Silvia Regina Valderramas 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 Sensors mechanical ventilation mucociliary clearance ventilator hyperinflation ICP wave morphology intracranial compliance intracranial pressure |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | mechanical ventilation mucociliary clearance ventilator hyperinflation ICP wave morphology intracranial compliance intracranial pressure |
| url | https://www.mdpi.com/1424-8220/24/21/7066 |
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