Department of Neurosurgery

Physiological Effects of Intrathoracic Pressure Regulation in Patients with Brain Injury or Intracranial Pathology

Principal Investigator: Dr. Ali Seifi, MD, FACP
Co-PI: David Wampler, PhD
Grant from Department of Defense, Army branch,  
Grant number: W81XWH-12-C-0181  

The CirQlator Intrathoracic Pressure Regulator (ITPR) has been developed indicated to increase circulation and blood pressure in non-spontaneously breathing patients when the patient has low blood circulation, including decreased circulation of blood to the brain. When inserted within a standard respiratory circuit between the patient and a ventilation source, the ITPR generates negative pressure during the expiratory phase, thus creating subatmospheric intrathoracic pressure between the periods of positive pressure ventilations.  The increase in venous return results in increased circulation to the heart and brain. The current study is intended to evaluate the hemodynamic effects of IPR therapy, in up to 30 patients with compromised cerebral circulation, in whom a functioning intracranial pressure-monitoring device is in place. The purpose of the study is to evaluate the physiological response to application of the ITPR in patients with compromised cerebral circulation. The study hypothesis is that the physiological effects of the ITPR will improve cerebral circulation, without negative impact on other physiologic parameters and without significant pulmonary or cardiac adverse events, in patients with brain injury or intracranial pathology.