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The use of ketamine in acute brain injury patients.

Phase 1
Conditions
Traumatic Brain Injury patients requiring sedation to control the intracranial pressure (ICP).
Therapeutic area: Diseases [C] - Injuries, poisonings, and occupational diseases [C21]
Registration Number
EUCTR2017-004698-15-BE
Lead Sponsor
Z Leuven / KU Leuven
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
100
Inclusion Criteria

* Traumatic brain injury patients
* Age = 18 years
* Admitted to the ICU
* Within 72 hours after admission to the initial hospital:
1)ICP monitor in place (parenchymal probe, ventricular catheter, or both)
2)Requiring sedation

Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 100
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 100

Exclusion Criteria

* Known pregnancy and/or lactation
* Imminent or actual brain death upon inclusion
* Allergy or intolerance to the study medication
* Pre-existing neurocognitive disorders, pre-existing congenital or non-congenital brain dysfunction.
* Inability to obtain informed consent
* Inclusion in an IMP-RCT of which the PI indicates that co-inclusion specifically in the BIKe study is prohibited.
* Therapy restriction code upon inclusion.
* Porphyria
* Glaucoma

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Main Objective: To demonstrate that associating ketamine to the sedative regime for ICP control in TBI, results in a reduction of the therapeutic intensity of ICP reducing measures, assessed by the TIL score.;Secondary Objective: To demonstrate that ketamine does not cause an increase in ICP.;Primary end point(s): Primary efficacy endpoint: Reduction in cumulative daily TIL score. Primary safety endpoint: The number of high intracranial pressure episodes defined as an ICP >22 mmHg for >20 minutes [1,2].<br>;Timepoint(s) of evaluation of this end point: Daily
Secondary Outcome Measures
NameTimeMethod
Secondary end point(s): * The average intracranial pressure (mmHg) per 24h <br>* Total duration of the first episode of sedative treatment (hours) <br>* Total duration of the first episode of mechanical ventilation <br>* Total dose of propofol in mg per 24 hours <br>* Total dose of midazolam in mg per 24 hours <br>* Length of stay in the Intensive Care Unit (ICU) <br>* Length of stay in the hospital (days) <br>* Average daily Richmond agitation and sedation score (RASS) (addendum 2) per hour <br>* Delirium-free days, defined with the Intensive Care Delirium Screening Checklist (ICDSC) or Confusion Assessment Method-ICU (CAM-ICU) every 8 hours (ICDSC) <br>* Extended Glasgow Outcome Score (GOSE) at 6 months after the onset of brain injury <br>* The incidence of barbiturate coma <br>* Incidence of decompressive craniectomy <br>* Incidence of Propofol-Related Infusion Syndrome (PRIS)<br>;Timepoint(s) of evaluation of this end point: As described in E.5.2
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