Effects of Moderate Hyperventilation on Cerebral Hemodynamics, Oxygenation and Metabolism in Patients With Severe Traumatic Brain Injury
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 11
- 试验地点
- 1
- 主要终点
- intracranial pressure
研究概览
简要总结
Elevated intracranial pressure is a dangerous and potentially fatal complication after traumatic brain injury. Hyperventilation is a medical intervention to reduce elevated intracranial pressure by inducing cerebral vasoconstriction, which might be associated to cerebral ischemia and hypoxia.
The main hypothesis is that a moderate degree of hyperventilation is sufficient to reduce the intracranial pressure without inducing cerebral ischemia.
详细描述
In patients with severe traumatic brain injury (TBI), and with intracranial pressure-monitoring, brain tissue oxygen tension and/or microdialysis probes hyperventilation-tests are performed in the acute phase after trauma. Data are collected and TCCD measurements are performed at baseline, at the beginning of moderate hyperventilation, after prolonged moderate hyperventilation (for 50 minutes) and after return to baseline.
The present study aims to quantify potential adverse effects of moderate short-term hyperventilation during the acute phase of the severe TBI on cerebral hemodynamics, oxygenation, and metabolism.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •nonpenetrating traumatic brain injury
- •Glasgow coma scale <9 at presentation
- •Intracranial pressure monitoring
- •brain tissue oxygen tension monitoring and/or microdialysis monitoring
- •invasive mechanical ventilation with FIO2 <60% and PEEP <15 mbar
排除标准
- •decompressive craniectomy
- •pregnancy
- •pre-existing neurological disease
- •previous traumatic brain injury
- •acute cardiovascular disease
- •severe respiratory failure
- •acute on chronic liver disease
- •failure to obtain satisfactory bilateral TCCD signals
- •persisting hypovolemia or hemodynamic instability
研究组 & 干预措施
patients with severe TBI
Patients with severe TBI enrolled in the study undergo an hyperventilation test, in which the alveolar ventilation is increased by a stepwise increase in tidal volumes and respiratory rate until a reduction of etCO2 of 0.7 kPa is achieved.
干预措施: Hyperventilation test (Other)
结局指标
主要结局
intracranial pressure
时间窗: 10, 20, 50, 60 minutes after begin of the hyperventilation test
Change of intracranial pressure during moderate hyperventilation
次要结局
- cerebral flow velocity in the middle cerebral artery(20, 50, 60 minutes after begin of the hyperventilation test)
- brain tissue oxygenation (PbrO2)(10, 20, 50, 60 minutes after begin of the hyperventilation test)
- cerebral Lactate/ Pyruvate ratio(1 hour before initiation of the hyperventilation test, and 1 and 2 hours after begin of the hyperventilation test)