- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT00729261
A Prospective Trial of Elective Extubation in Brain Injured Patients.
A Prospective Trial of Elective Extubation in Brain Injured Patients Meeting Extubation Criteria for Ventilatory Support.
Identifying the optimal time of extubation in a brain injured population should improve patient outcome. Brain injured patients usually remain intubated due to concerns of airway maintenance. Current practice argues that unconscious patients need to remain intubated to protect their airways. More recent data however suggests that delaying extubation in this population increases pneumonias and worsens patient outcomes.
We designed a safety and feasibility study of randomizing brain injured patients into early or delayed extubation. The purpose was to gain insight into patient safety concerns and to obtain estimates of sample size needed for a larger study.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 1
Kontakter og lokationer
Studiesteder
-
-
Minnesota
-
Rochester, Minnesota, Forenede Stater, 55905
- Mayo Clinic
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Resolution or improvement of any pulmonary process requiring mechanical ventilation.
- Adequate gas exchange.
- Adequate ventilation.
- Respiratory rate to tidal volume ratio <105.
- Core body temperature < 38 degrees celsius.
- Hemoglobin > 8 grams per deciliter.
- No sedative medications for 2 hours.
Neurological requirements included:
- GCS ≤ 8.
- Intracranial pressure (ICP) < 15 cm of water and a cerebral perfusion pressure (CPP) > 60 mm Hg for patients with intracranial pressure monitors.
Exclusion Criteria:
- Age < 18 years.
- Lack of informed consent by the patients' surrogate.
- Dependence on mechanical ventilation for at least two weeks prior to enrollment.
- Patients with tracheostomies.
- Intubation instituted for therapeutic hyperventilation.
- Planned surgical or radiological intervention within the next 72 hours.
- Anticipated neurological or medically worsening conditions (i.e develop cerebral edema or vasospasm).
- Patients intubated for airway preservation due to airway edema (cervical neck injuries or surgery) as opposed to airway protection.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Enkelt gruppeopgave
- Maskning: Enkelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: armA I
Patients remain intubated until the patients Glasgow coma score improves to greater than 8.
|
patients remain intubated until their Glasgow coma scores improve to greater than 8.
|
|
Eksperimentel: arm 2
Patients that meet standard airway and ventilatory criteria for extubation but have a Glasgow coma score of less than or equal to 8 are immediately extubated.
|
Brian injured patients that remained intubation solely because of a depressed level of consciousness were randomized into immediate extubation or delayed extubation until their level of consciousness improved.All patients met standard ventilatory, and airway criteria for extubation.
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Ændret Rankin Score
Tidsramme: 6 måneder
|
6 måneder
|
Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
nosocomial pneumonias
Tidsramme: hospital discharge
|
hospital discharge
|
|
reintubations
Tidsramme: hospital discharge
|
hospital discharge
|
|
ICU length of stay
Tidsramme: hospital discharge
|
hospital discharge
|
|
hospital length of stay
Tidsramme: hospital discharge
|
hospital discharge
|
Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Studieleder: Edward M. Manno, M.D., Mayo Clinic
Publikationer og nyttige links
Generelle publikationer
- Coplin WM, Pierson DJ, Cooley KD, Newell DW, Rubenfeld GD. Implications of extubation delay in brain-injured patients meeting standard weaning criteria. Am J Respir Crit Care Med. 2000 May;161(5):1530-6. doi: 10.1164/ajrccm.161.5.9905102.
- Manno EM, Rabinstein AA, Wijdicks EF, Brown AW, Freeman WD, Lee VH, Weigand SD, Keegan MT, Brown DR, Whalen FX, Roy TK, Hubmayr RD. A prospective trial of elective extubation in brain injured patients meeting extubation criteria for ventilatory support: a feasibility study. Crit Care. 2008;12(6):R138. doi: 10.1186/cc7112. Epub 2008 Nov 10.
Hjælpsomme links
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 1210-04
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Hjerneskade
-
Virginia Polytechnic Institute and State UniversityTrukket tilbage
-
University of MinnesotaRekruttering
-
BraindexClinique de la SauvegardeAfsluttetAnæstesi | Brain MonitorFrankrig
-
Assistance Publique Hopitaux De MarseilleUkendt
-
National Institute of Mental Health (NIMH)AfsluttetKÆLEDYR | Brain Imaging | Cannabinoid | CB1Forenede Stater
-
GE HealthcareAfsluttetBrain Imaging | Billedbehandling af hele kroppenForenede Stater
-
Truway Health, Inc.Tilmelding efter invitationEvaluering af In-Vitro Cryo Terapeutiske Protokoller på Humane Celleprøver (TWH-CRYO-001) (CRYO-IVT)Cellular Injury and Post-Cryogenic Recovery | Kryogenisk cellulær stress | Kuldeinduceret cellulær skade | Termisk Skade Reaktion | Post-thaw levedygtighedsforringelse | Osmotisk Stressskade | Biomekanisk Skadesmodellering (In-Vitro) | Blunt Force Injuries to the Extremities (Cellular Injury Model) | Vævsskade... og andre forholdForenede Stater
-
Mayo ClinicAfsluttetBrain Imaging | Billedbehandling af hele kroppenForenede Stater
-
Hospital Universitari Son DuretaEspen; This research prize was funded by Nestle Nutrition Institute and...AfsluttetModerat til alvorligt traume, som defineret af en | Injury Severity Score (ISS) > 12 point var inkluderet i undersøgelsen.Spanien
-
Tang-Du HospitalIkke rekrutterer endnuPsykisk lidelse | Sociale medier | Brain Imaging
Kliniske forsøg med continued intubation
-
University of British ColumbiaUniversity of Utah; University of VirginiaUkendt
-
Zeliha AlicikusIkke rekrutterer endnuFedme | Luftvejskomplikation af anæstesi | Intubation; Svært eller mislykket
-
Government Medical College, HaldwaniAfsluttetIntubation; Svært
-
Tepecik Training and Research HospitalAfsluttet
-
Universitätsklinikum Hamburg-EppendorfAfsluttet
-
Kanuni Sultan Suleyman Training and Research HospitalRekrutteringIntubation | Intubation, Endotracheal | Intubationskomplikationer | Hurtig sekvensinduktion og intubation | Forsinket sekvensintubationTyrkiet (Türkiye)
-
Seoul National University HospitalAfsluttetEndotracheal intubation | Abdominal kirurgi | Kirurgisk snit | ElektroencefalogramSydkorea
-
Lawson Health Research InstituteAfsluttetIntubation | VideolaryngoskopiCanada
-
Centre Hospitalier Universitaire VaudoisRekrutteringAnæstesi | Luftvejskomplikation af anæstesi | Intubation; Svært eller mislykketSchweiz