Inspiratory Impedance as a Treatment for Traumatic Brain Injury

Traumatic head and neck injuries account for 16-33% of all war-related injuries and are a leading cause of mortality upon evacuation to a definitive care setting. Therapeutic advances are urgently needed for these soldiers. This application is focused on treating one of the most important determinants of outcome from severe head injury, the degree and duration of elevated intracranial pressure (ICP). New research in our animal laboratory has discovered that lowering intrathoracic pressures can result in a significant lowering of ICP. Building upon the positive results of the Phase 1 studies, two of the major objectives of this Phase 2 proposal are to a) evaluate the longer-term application of the Intrathoracic Pressure Regulator (ITPR) in an animal model of brain injury and b) establish proof of concept that application of the Impedance Threshold Device (ITD) and ITPR will result in a decrease in ICP and an increase in cerebral perfusion pressures in patients in need of increased brain perfusion. The successful development and deployment of a new device designed to immediately increase cerebral perfusion pressures or decrease elevated ICP or prevent the onset of elevated ICP following traumatic brain injury would be a major advance in treating battlefield head injuries.