Lung Collapse
Conditions
Keywords
Lung Inhomogeneity, Lung Collapse, Atelectasis, Mechanical Ventilation, EIT, Bed tilting, Positioning, Neurocritical Care, Unconsciousness, Acute Brain Disease, Preventive Strategy
Brief summary
Prevention of lung inhomogeneity is an essential part of preventive strategy in neurocritical care, reducing the risks of secondary brain damage from hypoxemia, hypo/hypercapnia or pneumonia.
Detailed description
In the monocentric, intervention, prospective, randomized study, the investigators will examine the effect of lateral tilting (routinely used in critical care) on the lung inhomogeneity that will be analyzed by electrical impedance tomography (EIT) in the unconscious patients with acute primary brain disease and artificial pulmonary ventilation. Two types of lateral tilting will be compared: manual positioning of body by nurse versus the bed tilting (15° lateral tilt, original company (LINET) and product brand name (Eleganza 5).
Interventions
DEVICEBed tilting
15° lateral tilt, original product brand name LINET Eleganza 5
OTHERBody positioning
Manual positioning of body by nurse: left side, back, right side, using positioning pillows
Sponsors
Charles University, Czech Republic
University of Sao Paulo
Technology Agency of the Czech Republic
Regional Hospital Liberec
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Investigator)
Masking description
Research Randomizer
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Primary brain disease * Hospitalization in Neurocenter, Neurointensive Care Unit * Age\>18 years * Unconsciousness * Artificial pulmonary ventilation
Exclusion criteria
* Intracranial hypertension * History of primary lung disease * The terminal stage of the disease * Refractory hemodynamic instability
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Atelectasis/collapse | up to 24 weeks | Assessed by electrical impedance tomography (EIT) or chest x-ray (CXR) at end of observation period |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluating oxygenation parameters | up to 24 weeks | Oxygen saturation |
| Evaluating hemodynamic parameters | up to 24 weeks | Hemodynamic monitoring: stroke volume variation (SVV) |
| Cost effectiveness measurement between two groups | up to 24 weeks | Therapeutic Intervention Scoring System (TISS) |
| Profiling pneumonia incidence | up to 24 weeks | Pneumonia score |
| Comparing duration of stay in Neurocenter Neurointensive Care Unit | up to 24 weeks | Days of hospitalization |
Countries
Czechia
Outcome results
None listed