Sodium-Lactate and Traumatic Brain Injury
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Purpose
The purpose of this study is to compare the effect of bolus of either sodium-lactate or mannitol on the evolution of intracranial pressure (ICP) during intracranial hypertensive episodes (IHE)
| Condition | Intervention | Phase |
|---|---|---|
|
Severe Trauma Brain Injury Intracranial Hypertension |
Drug: Mannitol, Sodium-Lactate |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Single Blind Primary Purpose: Treatment |
| Official Title: | Sodium-Lactate Versus Mannitol in the Treatment of Intracranial Hypertensive Episodes in Severe Traumatic Brain Injured Patients |
- Efficiency to decrease ICP during IHE episodes
- Number of successful treatment, neurological status (Glasgow outcome score) after one year of evolution
| Estimated Enrollment: | 34 |
| Study Start Date: | November 2003 |
| Estimated Study Completion Date: | November 2005 |
Osmotherapy with mannitol remains the first treatment currently recommended to treat intracranial hypertension in severe head injury.However, this treatment in not always efficient and is associated with side-effects and a transitory action. Hypertonic sodium-lactate, by its osmotic and energetic properties could be superior to mannitol to decrease ICP. Study objectives : to compare the effect of mannitol and sodium-lactate on ICP at the fourth hour after the start of infusion during IHE in severe traumatic brain injury (TBI) (main endpoint) ; to compare the percentage of successfully treated episodes between both treatments and to compare the neurological status after one year of evolution (glasgow outcome score)(secondary endpoints)
Patients inclusion : adult severe TBI (glasgow coma score < 9) < 66 yrs Exclusion criteria : polytrauma, bilateral fixed dilated pupils, motor score < 4, neurosurgery, prolonged episode of hypoxia or arterial hypotension, 34 patients included from november 2003 to november 2004 and randomized into two groups : MAN group receiving mannitol 20% 100 ml in 15 min (17 patients, 36 episodes of IHE treated) and LAC group receiving semimolar sodium-lactate 100 ml in 15 min (17 patients, 37 episodes of IHE treated). For ethical reasons a rescue treatment in a crossover fashion was performed for each episode of IHE when the randomized treatment failed.
Follow-up : one year after the TBI. Study end : november 30, 2005
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- age between 18 and 65 years
- severe traumatic brain injury
- prehospital glasgow coma scale < 9
- rapid neurological worsening before admission
Exclusion Criteria:
- neurosurgical intervention
- polytrauma
- bilatéral fixed dilated pupils
- motorscore < 4
- prolonged episode of hypoxia or arterial hypotension
- abundant rinorrhea
Contacts and Locations| France | |
| CHU de Nice | |
| Nice, Alpes Maritimes, France, 06006 | |
| Study Director: | Carole R ICHAI, MD-PhD |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00319345 History of Changes |
| Other Study ID Numbers: | CHUN-LM-0001 |
| Study First Received: | April 27, 2006 |
| Last Updated: | June 22, 2010 |
| Health Authority: | France: Institutional Ethical Committee |
Keywords provided by Institut d'Anesthesiologie des Alpes Maritimes:
|
Traumatic brain injury Intracranial pressure Osmotherapy |
Glasgow outcome score Mannitol Sodium-Lactate |
Additional relevant MeSH terms:
|
Hypertension Intracranial Hypertension Brain Injuries Vascular Diseases Cardiovascular Diseases Brain Diseases Central Nervous System Diseases Nervous System Diseases Craniocerebral Trauma Trauma, Nervous System |
Wounds and Injuries Mannitol Diuretics, Osmotic Diuretics Natriuretic Agents Physiological Effects of Drugs Pharmacologic Actions Cardiovascular Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 22, 2013