The Effect of Lateral Tilt on Ventilation Distribution in Lungs Assessed by Electrical Impedance Tomography

Study Overview
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Brief Summary
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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
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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).

Official Title
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The Effect of Lateral Tilt on Ventilation Distribution in Lungs Assessed by Electrical Impedance Tomography: A Pilot Prospective Randomized Study in Neurocritical Care

Conditions
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Lung Collapse

Intervention / Treatment
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* Device: Bed tilting
* Other: Body positioning


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Lateral tilt bed<br>Bed tilting (15° lateral tilt, original product brand name LINET Eleganza 5) | Device: Bed tilting<br>* 15° lateral tilt, original product brand name LINET Eleganza 5<br>|
| Experimental: Body positioning<br>Manual positioning of body by nurse. | Other: Body positioning<br>* Manual positioning of body by nurse: left side, back, right side, using positioning pillows<br>* Other names: Manual positioning of body by nurse;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Atelectasis/collapse | Assessed by electrical impedance tomography (EIT) or chest x-ray (CXR) at end of observation period | up to 24 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluating oxygenation parameters | Oxygen saturation | up to 24 weeks | 
| Evaluating hemodynamic parameters | Hemodynamic monitoring: stroke volume variation (SVV) | up to 24 weeks | 
| Cost effectiveness measurement between two groups | Therapeutic Intervention Scoring System (TISS) | up to 24 weeks | 
| Profiling pneumonia incidence | Pneumonia score | up to 24 weeks | 
| Comparing duration of stay in Neurocenter Neurointensive Care Unit | Days of hospitalization | up to 24 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lung Inhomogeneity, Lung Collapse, Atelectasis, Mechanical Ventilation, EIT, Bed tilting, Positioning, Neurocritical Care, Unconsciousness, Acute Brain Disease, Preventive Strategy