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Ventilator-associated pneumonia (VAP) is a common infection in critically ill patients, especially those with acute brain injuries, leading to increased mortality and longer ICU stays.
The mechanical insufflation/exsufflation (M-I/E) cough assist device improves outcomes in patients with neuromuscular disorders but its effects on brain-injured patients are largely unknown.
This study is conducted at a tertiary neurosurgical medical center and consists of two substudies. The prospective physiological study assessed the impact of M-I/E on hemodynamics and ICP in mechanically ventilated neurosurgical patients. The combined retrospective-prospective clinical study was performed to investigate the efficacy of M-I/E on occurence of VAP and other clinical outcomes.
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| Measure | Description | Time Frame |
|---|---|---|
| Mean blood pressure | In study one, mean blood pressure will be recorded during the incremental pressure changes in the study one | during the process of physiological study, up to 2 hours |
| Heart rate | In study one, heart rate will be recorded during the incremental pressure changes in the study one | During the process of physiological study, up to 2 hours |
| Rate of ventilator associated pneumonia | In study two, ventilator associated pneumonia is defined as pneumonia occurring in patients who have been mechanically ventilated for at least 48 hours. Pneumonia was diagnosed by clinical features (e.g., cough, fever, pleuritic chest pain) and by lung imaging. To derived the diagnosis of pneumonia, patient electronical record, lab results, and images were extracted from the electronical system. | Within 7 days after the onset of mechanical of ventilation |
| Measure | Description | Time Frame |
|---|---|---|
| Intracranial pressure | In study one, intracranial pressure will be recorded during the incremental pressure changes in the study one | During the process of physiological study, up to 2 hours |
| Length of stay in ICU |
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Inclusion Criteria:
Exclusion Criteria:
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Post-neurosurgical adult patients receiving mechanical ventilation
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| Name | Affiliation | Role |
|---|---|---|
| Zhonghua Shi, PhD,MD | Capital Medical University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Sanbo Brain Hospital, Capital Medical University | Beijing | Beijing Municipality | 100090 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40983845 | Derived | Zhang R, Zhang M, Zhang X, Liu Y, Li J, Wang H, Han S, Huang X, Shi Z. Safety and Efficacy of Mechanical Insufflation/Exsufflation Cough Assistance for Preventing Postoperative Pneumonia in Neurosurgical Patients: A Combined Physiological and Cohort Study. Neurocrit Care. 2026 Apr;44(2):587-596. doi: 10.1007/s12028-025-02386-y. Epub 2025 Sep 22. |
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| ID | Term |
|---|---|
| D053717 | Pneumonia, Ventilator-Associated |
| D001930 | Brain Injuries |
| ID | Term |
|---|---|
| D000077299 | Healthcare-Associated Pneumonia |
| D003428 | Cross Infection |
| D007239 | Infections |
| D011014 | Pneumonia |
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Days of ICU Stay
| Patients will be followed up until 28 days after surgery, discharged from hospital or dead, which ever came first,through study completion, an average of 1 year |
| Length of hospital stay | Days of hospital stay | Patients will be followed up until 28 days after surgery, discharged from hospital or dead, which ever came firstthrough study completion, an average of 1 year |
| Days of receiving mechanical ventilation | The duration from the start of mechanical ventilation to the weaning off from ventilator | Patients will be followed up until 28 days after surgery, discharged from hospital or dead, which ever came firstthrough study completion, an average of 1 year |
| D012141 |
| Respiratory Tract Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D007049 | Iatrogenic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |