Multicenter Pilot Study

Abstract

In the critical care setting, the focus of care during the first few weeks following acute brain injury is prevention of secondary brain injury by optimizing cerebral perfusion. Ensuring adequate oxygenation and perfusion of cerebral tissues requires attention to all of the body systems. Chest percussion therapy (CPT) promotes pulmonary hygiene and optimizes gas exchange by opening the alveoli. However, many patients with brain injury have intracranial pressure (ICP) monitoring, and conventional wisdom supports limiting activities such as CPT that may stimulate the patient and increase ICP. The purpose of this study was to explore the effects of CPT on ICP. Thirty participants were enrolled over a 6-month period. Data were collected at 1-minute intervals for 1 hour. Each patient was randomized to receive automated CPT (using specialty beds) for 10 minutes, starting at 10, 20, 30, or 40 minutes into the hour. There were no differences in mean ICP values before, during, or after CPT. This study provides evidence that it is safe to perform CPT in patients with ICP monitoring in situ. Pathophysiology of Brain InjuryBrain injury may result from external trauma, stroke, tumors, or other intracranial insult. Worldwide, brain injury is the leading cause of death and disability. In the United States, it has reached epidemic proportions. Each year, nearly 1.4 million Americans sustain a traumatic brain injury; 235,000

Barriers to conducting multicenter nursing research

“…Because the impact of nursing care was not described in the majority of studies that explored ICP treatment, the decision was made to add to the body of evidence by providing a description of current nursing practice from a multicenter perspective. The SIM City study was designed by doctoral and masters-prepared nurses experienced in research with previous experience collaborating on a multicenter research study [23].…”

Pulmonary complications and respiratory management in neurocritical care: a narrative review

“…CPT is safe in patients with ICP monitoring in situ. [83] Adequate sedation in neurocritical patients is paramount. Sedation can ease fear and anxiety, reduce ICP and cerebral oxygen consumption, facilitate tolerance of the endotracheal tube and MV, and reduce sympathetic nervous activity.…”