Cerebrovascular Disease
Conditions
Interventions
Standard Care Arm:Standard therapeutic regimen including:
- Basic life support protocols
- Guideline-directed pharmacotherapy
- Protocolized mechanical ventilation management
- Essential neurosurgical
CR Therapy Arm:Standard care PLUS individualized cardiac rehabilitation comprising:
- Exercise therapy (Aerobic/Resistance training)
- Remote Ischemic Preconditioning (RIPC)
- External Diaphragmatic P
Sponsors
The Third Affiliated Teaching Hospital of Nanjing Medical University (Changzhou Second People's Hospital)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Aged >=18 years. 2. Neurosurgical diagnosis of cerebrovascular disease (e.g., cerebral infarction, intracranial hemorrhage, intracranial aneurysm) or traumatic brain injury. 3. Documented cardiovascular comorbidity including: Coronary artery disease (CAD), Heart failure (NYHA Class I-III), Arrhythmia requiring medical intervention or Hypertension (per ESC 2023 criteria). 4. Requiring invasive mechanical ventilation for >48 hours. 5. Hemodynamically stable for CR initiation. 6. Written informed consent provided by legally authorized representative.
Exclusion criteria
Exclusion criteria: 1. Severe end-organ dysfunction or life-threatening comorbidities: Cardiac: LVEF =20, or Renal: eGFR 72h (per KDIGO/AASLD/ACC guidelines). 2. Uncontrolled hemorrhagic risk or hypertension: Active bleeding requiring transfusion >2U RBC/24h, or Refractory hypertension (SBP >180 mmHg despite triple therapy). 3. Pregnancy/lactation: Positive serum ß-hCG test, or Breastfeeding within 6 months postpartum. 4. Prior exposure to structured cardiac rehabilitation: Completion of =3 sessions in Phase II/III CR program within 2 years. 5. Non-compliance: Inability to adhere to protocol (dementia/CDR =2, substance abuse), or Withdrawal of consent during screening. 6. Irreversible neurological devastation: Vegetative state (CRS-R <5), or Brain death confirmation per AAN criteria.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Stroke Volume;Intensive Care Unit Length of Stay; | — |
Secondary
| Measure | Time frame |
|---|---|
| Total Hospitalization Costs; | — |
Countries
China
Contacts
Public ContactMinghai Wang
The Third Affiliated Teaching Hospital of Nanjing Medical University (Changzhou Second People's Hospital)
Outcome results
None listed