- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04870983
The Dynamic Change of MMN in Patients With Sepsis Associated Encephalopathy
The Dynamic Change of Mismatch Negativity is More Associated With Sepsis Associated Encephalopathy and Prognosis at Discharge
Sepsis-associated encephalopathy (SAE), is one of the most common organ dysfunction during the acute phase in sepsis and septic shock. Electroencephalogram (EEG) and auditory evoked potentials (AEPs), which reflect different aspects of brain function, are the most commonly used neurophysiological indices to detect acute brain dysfunction in critically ill patients including sepsis and septic shock. AEPs show the systemic responsiveness of the central nervous to auditory stimuli, so they can be considered a direct measure of brain responsiveness. Mismatch negativity (MMN) is a change-specific component of ERPs, which elicited by a deviant stimulus occurring in a sequence of repetitive stimuli. This component is thought to represent the automatic and unconscious detection of acoustic changes which requires good perceptual discriminative capacity and iconic memory. The peaks of MMN appear at 100 ~ 250 ms from deviant stimulus onset; with increasing magnitude of stimulus change, the peak latency of MMN was shortened and the amplitude increased. Since MMN can be elicited even in the absence of attention, subjects do not need to actively participate. The MMN has been extensively demonstrated to be used in the prediction of awakening in comatose patients for various reasons, and also has been reported to predict awakening in deeply sedated critically ill patients recently. However, it remains unclear whether SAE affects MMN in amplitude and latency that reflects cognitive processing of the auditory information.
Patients with sepsis and septic shock who met the inclusion criteria were screened daily on the CAM-ICU scale, and those with positive CAM-ICU were diagnosed with SAE.All patients were tested for event-evoked potentials on Day 1 and Day 3 after inclusion and were followed up to Day 28 after discharge. The investigators intend to observe the dynamic change of MMN amplitude and latency between SAE and non-SAE groups. Logic regression analysis was used to determine whether the change of MMN was a predictor of SAE.
Study Overview
Status
Detailed Description
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Beiyuan Zhang, M.S.
- Phone Number: +86-025-83106666-40400
- Email: 1083537599@qq.com
Study Locations
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Jiangsu
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Nanjing, Jiangsu, China, 210008
- Recruiting
- Nanjing Drum Tower Hospital
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Contact:
- Beiyuan Zhang, M.S.
- Phone Number: 15005170137
- Email: 1083537599@qq.com
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- ages between 18 and 80 years;
- expected stay in the ICU of > 72 h;
- patients diagnosed with sepsis or septic shock;
- informed consent was signed by the patient or relatives;
Exclusion Criteria:
- at terminal stage of disease;
- primary brain injury (such as traumatic brain injury, stroke, cardiac arrest, intracranial infection, epilepsy, Alzheimer's disease, Parkinson disease and meningitis etc.);
- acute mental deterioration secondary to non-septic metabolic disorders with organ dysfunction (hepatic encephalopathy, pulmonary encephalopathy, severe electrolyte imbalance, severe blood glucose disorders etc.);
- history of craniocerebral surgery;
- psychiatric illness;
- use of psychiatric medications;
- impaired hearing; participated in other clinical trial;
- pregnant or lactating women;
- expected death within 72 h after admission.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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SAE group
SAE was defined as cerebral dysfunction in the presence of sepsis or septic shock and the absence of any of the exclusion criteria.
For patients undergoing sedation during the ICU stay, the GCS scores were evaluated before sedation; for patients who have been sedated prior to ICU admission, the assumed GCS scores, i.e., the scores measured before any administration of sedative/relaxant drug were used for analysing; for postoperative patients, the GCS scores measured before surgery was used.
The CAM-ICU was assessed daily by the nurse or the physician in charge of the patient during the ICU stay.
For patients who were sedated, spontaneous awakening trials were performed daily; the longest evaluate time after withdrawal of sedation was 24 h during the trials.
In this evaluation period, patients should be awake to evaluate their consciousness, and they were diagnosed of SAE if the patients were not awake.
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non-SAE group
The patient was diagnosed with sepsis or septic shock but could not be diagnosed with SAE
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
the dynamic change of mismatch negativity(MMN) amplitude
Time Frame: Day 1 and day 3 after admission
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μv
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Day 1 and day 3 after admission
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the dynamic change of MMN incubation period
Time Frame: Day 1 and day 3 after admission
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ms
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Day 1 and day 3 after admission
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Burst suppression
Time Frame: Day 1 and day 3 after admission
|
Yes or no
|
Day 1 and day 3 after admission
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Periodic discharges
Time Frame: Day 1 and day 3 after admission
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Yes or no
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Day 1 and day 3 after admission
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Normal background
Time Frame: Day 1 and day 3 after admission
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Yes or no
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Day 1 and day 3 after admission
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Collaborators and Investigators
Sponsor
Investigators
- Study Director: Wenkui Yu, M.D., The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Publications and helpful links
General Publications
- Cotena S, Piazza O. Sepsis-associated encephalopathy. Transl Med UniSa. 2012 Jan 18;2:20-7. Print 2012 Jan.
- Azabou E, Rohaut B, Porcher R, Heming N, Kandelman S, Allary J, Moneger G, Faugeras F, Sitt JD, Annane D, Lofaso F, Chretien F, Mantz J, Naccache L, Sharshar T; GENeR** (Groupe d'Explorations Neurologiques en Reanimation). Mismatch negativity to predict subsequent awakening in deeply sedated critically ill patients. Br J Anaesth. 2018 Dec;121(6):1290-1297. doi: 10.1016/j.bja.2018.06.029. Epub 2018 Sep 4.
- Rinaldi S, Consales G, De Gaudio AR. Changes in auditory evoked potentials induced by postsurgical sepsis. Minerva Anestesiol. 2008 Jun;74(6):245-50. Epub 2008 Apr 30.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MMN in SAE
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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