Effects of Dexmedetomidine on Inflammatory Cytokines in Patients With Aneurysmal Subarachnoid Hemorrhage
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
Ohio
-
Cincinnati, Ohio, United States, 45219
- University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Aneurysmal subarachnoid hemorrhage
- World Federation of Neurological Surgeons (WFNS) grade 4-5 (see table below)
- Surgical intervention with clip or coil
- Placement of cerebrospinal fluid drain (lumbar or ventricular)
- Mechanically ventilated at start of infusion
Exclusion Criteria:
- Hemodynamic instability (SBP < 100, HR <60, or on continuous infusion of catecholamines) at screening
- Heart failure class III or IV (New York Heart Association)
- Renal failure (RIFLE classification - see table below)
- Liver failure (serum protein < 3 g/dL and total bilirubin > 5 mg/dL)
- Known or suspected brain death
- Pregnancy
- Unable to receive dexmedetomidine within 48 hours of injury and 4 hours of surgery
- Allergy to dexmedetomidine
- Prisoners
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
ACTIVE_COMPARATOR: Propofol
|
5-80 mcg/kg/min
|
|
EXPERIMENTAL: Dexmedetomidine
|
0.2-1.5 mcg/kg/hr
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Changes between serum and CSF cytokines over 48 hours
Time Frame: 0, 24 and 48 hours
|
Measure the baseline level (at enrollment) of inflammatory markers tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), glial fibrially acidic protein (GFAP), and malondialdehyde (MDA) as measured in both serum and cerebrospinal fluid (CSF) in 10 patients with aneurysmal subarachnoid hemorrhage (aSAH).
|
0, 24 and 48 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Sedative and analgesic medication requirements
Time Frame: 2 weeks
|
Sedation requirements between the two groups will be assessed by comparing total daily dose and average daily fentanyl doses in the 24 hours following surgery.
The total number of patients requiring propofol rescue in the dexmedetomidine group and the total daily dose and average daily dose of the propofol used in the dexmedetomidine group will be recorded.
|
2 weeks
|
|
Sedation scores (RASS and CAM-ICU)
Time Frame: 2 weeks
|
2 weeks
|
|
|
ICU length of stay
Time Frame: 2 weeks
|
2 weeks
|
|
|
Hospital length of stay
Time Frame: 2 weeks
|
2 weeks
|
|
|
Glasgow Outcome Scores Extended (GOSE) at discharge
Time Frame: 2 weeks
|
2 weeks
|
|
|
Incidence of delayed cerebral ischemia (DCI)
Time Frame: 2 weeks
|
2 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Cardiovascular Diseases
- Vascular Diseases
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Intracranial Hemorrhages
- Hemorrhage
- Subarachnoid Hemorrhage
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anesthetics, Intravenous
- Anesthetics, General
- Anesthetics
- Analgesics, Non-Narcotic
- Adrenergic alpha-2 Receptor Agonists
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Hypnotics and Sedatives
- Propofol
- Dexmedetomidine
Other Study ID Numbers
Other Study ID Numbers
- 11-11-22-01
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