Comparison Between Different Types of Oxygen Treatment Following Traumatic Brain Injury
The purpose of this study is to study the effects of EARLY (no more than 24 four hours from injury) administration of extra amounts of oxygen on traumatic brain injury.
Traumatic Brain Injury
Procedure: Hyperbaric Oxygen Treatment (HBOT)
Procedure: Enhanced Oxygen Treatment (Enhanced FiO2)
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Factorial Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Hyperbaric and Normobaric Oxygen in Severe Brain Injury|
- Cerebral Metabolic Rate of Oxygen (CMRO2)
- Microdialysis Lactate
- Brain tissue oxygen (PtO2)
- Intracranial Pressure (ICP)
- Microdialysis-Glycerol,Glucose,Pyruvate,Lactate/Pyruvate Ratio
- Cerebral Spinal Fluid (CSF) Lactate
- Arterial-Venous Oxygen Difference (AVDO2)
- Cerebral Blood Flow (CBF)
- Cerebral Spinal Fluid Isoprostane
- Bronchial-Alveolar Lavage Cytokines
|Study Start Date:||November 2002|
|Study Completion Date:||November 2008|
|Primary Completion Date:||November 2007 (Final data collection date for primary outcome measure)|
Brain injury continues to be a major cause of death and disability throughout the world. Our investigations of hyperbaric oxygen treatment (HBOT) indicate that it is a relatively safe treatment that has promise as a potential therapy for patients with severe traumatic brain injury (TBI). The goals of the present proposal are to further elucidate the mechanisms of action of HBOT on severe TBI and to test hypotheses that are crucial to the possible future design of a Phase III clinical trial.
Our initial prospective clinical trial to assess the effectiveness of HBOT in severe TBI documented very significant improvement in survival, particularly in certain subgroups of patients. In our second study, HBOT was found to improve cerebral aerobic metabolism in patients with severe TBI, reduce elevated intracranial pressure, and had a persistent positive effect for at least six hours following the treatment. Our work suggests that HBOT allows the brain to utilize increased amounts of oxygen more efficiently following treatment.
Recently, increasing the inspired oxygen concentration (FiO2) to 100% has been proposed as an alternative way of delivering supranormal levels of oxygen to severe TBI patients. Experimental investigation in the fluid percussion rat model using HBOT at 1.5 ATA (atmospheres absolute) for 60 minutes followed by 3 hours of 100%fraction of inspired oxygen (FiO2) have given optimum results in terms of mitochondrial functional and neurobehavioral improvement.
The clinical and experimental data together provide a strong basis for the restorative effect of the combination of hyper- and normobaric hyperoxia on severe TBI. The goal of this study is to evaluate the use of HBOT and 100% FiO2 separately and in combination.
|United States, Minnesota|
|Hennepin County Medical Center|
|Minneapolis, Minnesota, United States, 55415|
|Principal Investigator:||Gaylan L Rockswold, M.D., PhD||Hennepin County Medical Center, Minneapolis|
|Study Director:||Sarah B Rockswold, M.D.||Hennepin County Medical Center, Minneapolis|