Brain Function and Blood Flow Monitoring During PEEP Respiratory Therapy in Critically Ill Patients with Acute Brain Injury

What this Trial Is About

Mechanical ventilation is often necessary for critically ill patients with acute brain injury, but how certain ventilator strategies like positive end-expiratory pressure PEEP and lung recruitment maneuvers affect brain function is not fully understood. This study aims to evaluate changes in brain electrical activity and cerebral blood flow during these ventilator interventions in neurocritical care patients. It investigates the relationship between ventilator settings and cerebral physiology to better understand brain-lung interactions in this population. Participants will undergo clinically indicated recruitment maneuvers and PEEP adjustments as part of their respiratory management. During these interventions, continuous monitoring using scalp electroencephalography EEG, transcranial Doppler ultrasound, invasive arterial blood pressure, end-tidal carbon dioxide, and other clinical variables will be performed. The study will record physiological data during baseline, intervention, and recovery periods lasting about 30 minutes to assess cerebral and systemic responses. Throughout the study, researchers will analyze EEG signals to assess cortical activity changes and measure cerebral blood flow velocity and neurovascular coupling. They will also monitor systemic hemodynamics and respiratory parameters to explore how ventilator-induced changes influence brain function. This comprehensive monitoring aims to inform future individualized ventilation strategies for patients with acute brain injury, with study participation lasting for the duration of these ventilator interventions and monitoring sessions.

Brain Monitoring During PEEP-Based Respiratory Therapy in Critically Ill Patients