Feasibility of Improving Cerebral Autoregulation in Acute Intracerebral Haemorrhage (BREATHE-ICH) Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 18
- 试验地点
- 1
- 主要终点
- Post Stroke Morbidity and Mortality
研究概览
简要总结
In the UK, 23,000 (15%) of the 150,000 people who suffer a stroke each year have bleeding in the brain, also referred to as acute intracerebral haemorrhage (ICH). An Autoregulation Index (ARI) can be assigned between 0 and 9 (0 being poor and 9 being the most efficient CA observed) to gauge how good the control over blood flow is at a given time. Dynamic CA (dCA) is a measure of the response of cerebral blood flow (CBF) to rapid changes in blood pressure (BP), and several key studies have shown impaired dCA post-acute ICH. The most recent study demonstrated that dCA impairment lasts up to 12 days. This is particularly important to understand, since our preliminary work has recently shown that changes in carbon dioxide using simple breathing exercises can improve Autoregulation.
Unfortunately, there are limited non-pharmacological management options and significant opportunities to improve patient outcome in ICH. The proposed study addresses this area, by investigating whether a simple breathing exercise in survivors of ICH is safe, feasible and effective in reducing brain injury by improving cerebral autoregulation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Basic Science
- 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
- •Clinical diagnosis of a haemorrhagic stroke within 48 hours of onset (for patients waking with a stroke, time of onset will be taken to be the time when the patient was last asymptomatic)
- •Able and willing to give informed consent
- •Male or female, aged 18 years or above
- •Able (in the Investigator's opinion) and willing to comply with all study requirements
- •Willing to allow his or her General Practitioner (GP) to be notified of participation in the study
排除标准
- •Male or Female, aged under 18 years
- •Significant previous airways disease (formal diagnosis of moderate or severe airways disease and having treatment for this respiratory condition - via inhalers or specialist input)
- •Unable (in the Investigator's opinion) or unwilling to comply with any study requirements
- •Female participants who are pregnant, lactating or planning pregnancy during the course of the study
- •Clinical diagnosis of stroke greater than 48 hours from onset
- •Having had a resolved transient ischaemic attack (TIA) (i.e. neurological symptoms completely resolved upon hospital presentation)
- •Co-morbidity with anticipated life expectancy less than 3 months
研究组 & 干预措施
Hyperventilation Protocol
This will involve sustained periods of 90-seconds of hyperventilation at two levels (-5mmHg and -10mmHg below baseline EtCO2) to a maximum lower level threshold of EtCO2 24mmHg/CBFV 33cm/s regulated using a metronome. Two-minute washout periods of normal respiration will be allowed between successive measurements. Each incremental reduction in pCO2 will be repeated on two occasions during the same session. Further assessments will be conducted 10-14 days following baseline assessments.
干预措施: Hypocapnia via Hyperventilation Protocol (Other)
结局指标
主要结局
Post Stroke Morbidity and Mortality
时间窗: 14 days
Determined using Modified Rankin Scale 0 - No symptoms 1. \- No significant disability, despite symptoms; able to perform all usual duties and activities 2. \- Slight disability; unable to perform all previous activities but able to look after own affairs without assistance 3. \- Moderate disability; requires some help, but able to walk without assistance 4. \- Moderate severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance 5. \- Severe disability; bedridden, incontinent, and requires constant care 6- Death
The percentage of measurements rejected because of aspects related to data quality during the analysis protocol, with recorded reasons
时间窗: 14 days
The percentage of recruited subjects in whom values for the following cerebral haemodynamic parameters can be derived
时间窗: 14 days
* % change in CBFv at baseline and in response to a hyperventilation manoeuvre in the acute (\<48 hours) and sub-acute (10 to 14 days) periods * Autoregulation index * % change in CBFv at baseline and in response to a hyperventilation manoeuvre in the acute (\<48 hours) and sub-acute (10 to 14 days) periods * Autoregulation index
The percentage of recruited subjects able to comply with the full measurement protocol
时间窗: 14 days
次要结局
未报告次要终点