Lung Protective Ventilation for Brain Injury
(NEUROVENT Trial)
Trial Summary
What is the purpose of this trial?
Patients who experience lung injury are often placed on a ventilator to help them heal; however, if the ventilator volume settings are too high, it can cause additional lung injury. It is proven that using lower ventilator volume settings improves outcomes. In patients with acute brain injury, it is proven that maintaining a normal partial pressure of carbon dioxide in the arterial blood improves outcomes. Mechanical ventilator settings with higher volumes and higher breathing rates are sometimes required to maintain a normal partial pressure of carbon dioxide. These 2 goals of mechanical ventilation, using lower volumes to prevent additional lung injury but maintaining a normal partial pressure of carbon dioxide, are both important for patients with acute brain injury. The investigators have designed a computerized ventilator protocol in iCentra that matches the current standard of care for mechanical ventilation of patients with acute brain injury by targeting a normal partial pressure of carbon dioxide with the lowest ventilator volume required. This is a quality improvement study with the purpose of observing and measuring the effects of implementation of a standard of care mechanical ventilation protocol for patients with acute brain injury in the iCentra electronic medical record system at Intermountain Medical Center. We hypothesize that implementation of a standardized neuro lung protective ventilation protocol will be feasible, will achieve a target normal partial pressure of carbon dioxide, will decrease tidal volumes toward the target 6 mL/kg predicted body weight, and will improve outcomes.
Research Team
Colin K Grissom, MD
Principal Investigator
Intermountain Health Care, Inc.
Eligibility Criteria
This trial is for adults (18+) with acute brain injury, either from non-traumatic causes like stroke or anoxic brain injury, or from traumatic events. They must be starting mechanical ventilation in the emergency department or ICU at an Intermountain Healthcare hospital.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Implementation of neuro lung protective ventilation protocol targeting normal arterial partial pressure of carbon dioxide with the lowest tidal volume possible
Follow-up
Participants are monitored for quality of life and health care utilization after discharge
Treatment Details
Interventions
- Lung Protective Ventilation
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Who Is Running the Clinical Trial?
Colin Grissom
Lead Sponsor