{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:38:48Z","timestamp":1777927128753,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"20","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>Patient position change and tracheal suctioning are routine interventions in mechanically ventilated traumatic brain injury (TBI) patients. We sought to better understand the impact of these interventions on intracranial pressure (ICP) and cerebral hemodynamics. We conducted a prospective study in TBI patients requiring ICP monitoring. The timing of position changes and suctioning episodes were recorded with concurrent blood pressure and ICP measurements. We collected data on 460 patient position changes and 204 suctioning episodes over 2404\u2009h in 18 ventilated patients (mean age 34 [13] years, median Glasgow Coma Score 4 [3\u20137]). We recorded 24 (20\u201331) positioning and 11 (6\u201318) suctioning episodes per patient, with 54% and 39% of position changes associated with ICP \u226522\u2009mm Hg and cerebral perfusion pressure (CPP) &lt;60\u2009mm Hg, respectively, and 22% and 27% of suctioning episodes associated with an ICP \u226522\u2009mm Hg and CPP &lt;60\u2009mm Hg. The median change in ICP was 11 (6\u201316) mm Hg after position changes and 3 (1\u20139) mm Hg after suctioning. Reduction in CPP to &lt;60\u2009mm Hg lasted \u226510\u2009min in 17% of positioning and 11% of suctioning episodes. The baseline ICP and its amplitude were both predictive of a rise in ICP \u226522\u2009mm Hg after positioning and suctioning episodes, whereas cerebral autoregulation was not. Baseline CPP was predictive of a decrease in CPP &lt;60\u2009mm Hg after both interventions. Increases in ICP and reductions in CPP are common following patient positioning and tracheal suctioning episodes. Frequently, these changes are substantial and sustained.<\/jats:p>","DOI":"10.1089\/neu.2019.6873","type":"journal-article","created":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T01:58:34Z","timestamp":1589421514000},"page":"2227-2233","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Effects of Routine Position Changes and Tracheal Suctioning on Intracranial Pressure in Traumatic Brain Injury Patients"],"prefix":"10.1177","volume":"37","author":[{"given":"Anatole","family":"Harrois","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Level 5, Royal Melbourne Hospital, Parkville, Victoria, Australia."},{"name":"Department of Anesthesia and Surgical Intensive Care, Paris Sud University, Orsay, France."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R","family":"Anstey","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Level 5, Royal Melbourne Hospital, Parkville, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam M","family":"Deane","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Level 5, Royal Melbourne Hospital, Parkville, Victoria, Australia."},{"name":"Center for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Craig","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Level 5, Royal Melbourne Hospital, Parkville, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew A","family":"Udy","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Center, Monash University, Melbourne, Victoria, Australia."},{"name":"Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia."},{"name":"Intensive Care Unit, the Alfred Hospital, Melbourne, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"McNamara","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Royal Perth Hospital, Perth, Western Australia, Australia."},{"name":"Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rinaldo","family":"Bellomo","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Level 5, Royal Melbourne Hospital, Parkville, Victoria, Australia."},{"name":"Center for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australia."},{"name":"Australian and New Zealand Intensive Care Research Center, Monash University, Melbourne, Victoria, Australia."},{"name":"Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,10,7]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002205"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2018.05.012"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000001432"},{"key":"e_1_3_4_5_2","first-page":"217","article-title":"Increasing frequency of critically ill patient turns is associated with a reduction in pressure injuries","volume":"20","author":"Darvall J.N.","year":"2018","unstructured":"Darvall J.N., , Mesfin L., , and Gorelik A. (2018). Increasing frequency of critically ill patient turns is associated with a reduction in pressure injuries. Crit. Care Resusc. 20, 217\u2013222.","journal-title":"Crit. Care Resusc"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2005.14.6.476"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008506-200201000-00010"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0147-9563(96)80065-3"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199912000-00028"},{"key":"e_1_3_4_10_2","first-page":"51","article-title":"Which is safer to avoid an increase in ICP after endotracheal suctioning in severe head injury: intravenous or endotracheal lidocaine?","volume":"3","author":"Rodrigues","year":"2013","unstructured":"Rodrigues. (2013). Which is safer to avoid an increase in ICP after endotracheal suctioning in severe head injury: intravenous or endotracheal lidocaine?. J. Neurol. Res. 3, 51\u201355.","journal-title":"J. Neurol. Res"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01405841"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01376517-198504000-00005"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-198107000-00006"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/01376517-199310000-00006"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182514eb6"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2571-7"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-016-2932-z"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2007.03.003"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/JNN.0000000000000077"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2010.10.002"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2017.12.012"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-007-9012-4"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-199707000-00003"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/ANA.0b013e31826a75b1"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000132546.79769.91"},{"issue":"20","key":"e_1_3_4_26_2","first-page":"365","article-title":"Does tracheal lidocaine instillation reduce intracranial pressure changes after tracheal suctioning in severe head trauma?","author":"da Silva P.S.L.","year":"2019","unstructured":"da Silva P.S.L., , de Aguiar V.E., , and Fonseca M.C.M. (2019). Does tracheal lidocaine instillation reduce intracranial pressure changes after tracheal suctioning in severe head trauma?. A, prospective, randomized crossover study. Pediatr. Crit. Care Med. 20, 365\u2013371.","journal-title":"A"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.1983.tb00326.x"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0266-612X(87)90029-0"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-198403000-00003"}],"container-title":["Journal of Neurotrauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/neu.2019.6873","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2019.6873","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2019.6873","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:35:38Z","timestamp":1777674938000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/neu.2019.6873"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":28,"journal-issue":{"issue":"20","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1089\/neu.2019.6873"],"URL":"https:\/\/doi.org\/10.1089\/neu.2019.6873","relation":{},"ISSN":["0897-7151","1557-9042"],"issn-type":[{"value":"0897-7151","type":"print"},{"value":"1557-9042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10]]}}}