{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T06:23:39Z","timestamp":1770272619083,"version":"3.49.0"},"reference-count":45,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T00:00:00Z","timestamp":1730505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Patients with acute brain injury (ACI) often require mechanical ventilation (MV) and are subject to pulmonary complications, thus justifying the use of Airway Clearance Techniques (ACTs), but their effects on intracranial pressure (ICP) are unknown. This study investigates the neurological and hemodynamics safety of an ACT called ventilator hyperinflation (VHI) in patients with ACI. This was a randomized clinical equivalence trial, which included patients aged \u2265 18 years with a clinical diagnosis of hemorrhagic stroke, with symptom onset within 48 h. The participants were randomly allocated to the Experimental Group (EG, n = 15), which underwent VHI followed by tracheal aspiration (TA), and the Control Group (CG, n = 15), which underwent TA only. Neurological safety was verified by analyzing the morphology of the ICP wave through the non-invasive B4C sensor, which detects bone deformation of the skull, resulting in a P2\/P1 ratio and TTP, and hemodynamics through a multi-parameter monitor. Evaluations were recorded during five instances: T1 (baseline\/pre-VHI), T2 (post-VHI and before TA), T3 (post-TA), T4 and T5 (monitoring 10 and 20 min after T3). The comparison between groups showed that there was no effect of the technique on the neurological variables with a mean P2\/P1 ratio [F (4,112) = 1.871; p = 0.120; np2 = 0.063] and TTP [F (4,112) = 2.252; p = 0.068; np2 = 0.074], and for hemodynamics, heart rate [F (4,112) = 1.920; p = 0.112; np2 = 0.064] and mean arterial pressure [F(2.73, 76.57) = 0.799; p = 0.488; np2 = 0.028]. Our results showed that VHI did not pose a neurological or hemodynamics risk in neurocritical patients after ACI.<\/jats:p>","DOI":"10.3390\/s24217066","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T10:57:20Z","timestamp":1730717840000},"page":"7066","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Neurological and Hemodynamics Safety of an Airway Clearance Technique in Patients with Acute Brain Injury: An Analysis of Intracranial Pressure Pulse Morphology Using a Non-Invasive Sensor"],"prefix":"10.3390","volume":"24","author":[{"given":"Daniela de Almeida","family":"Souza","sequence":"first","affiliation":[{"name":"Postgraduate Program in Internal Medicine and Health Sciences, Empresa Brasileira de Servi\u00e7os Hospitalares, Universidade Federal do Paran\u00e1, Curitiba 80060-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5767-9101","authenticated-orcid":false,"given":"Gisele Francini","family":"Devetak","sequence":"additional","affiliation":[{"name":"Empresa Brasileira de Servi\u00e7os Hospitalares, Universidade Federal do Paran\u00e1, Curitiba 80060-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina Wolff","family":"Branco","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Internal Medicine and Health Sciences, Universidade Federal do Paran\u00e1, Curitiba 80060-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinaldo Luz","family":"Melo","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Internal Medicine and Health Sciences, Empresa Brasileira de Servi\u00e7os Hospitalares, Universidade Federal do Paran\u00e1, Curitiba 80060-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Lucas","family":"Tonial","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universidade Federal do Paran\u00e1, Curitiba 80060-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Marcia","family":"Delattre","sequence":"additional","affiliation":[{"name":"Department of Prevention and Rehabilitation in Physiotherapy, Universidade Federal do Paran\u00e1, Curitiba 80060-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7295-2439","authenticated-orcid":false,"given":"Silvia Regina","family":"Valderramas","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Internal Medicine and Health Sciences, Universidade Federal do Paran\u00e1, Curitiba 80060-000, Brazil"},{"name":"Department of Prevention and Rehabilitation in Physiotherapy, Universidade Federal do Paran\u00e1, Curitiba 80060-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40635-023-00587-3","article-title":"Mastering the brain in critical conditions: An update","volume":"12","author":"Robba","year":"2024","journal-title":"Intensive Care Med. 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