Transcranial Doppler on Admission of Patients With Mild to Moderate Traumatic Brain Injury (TCD)
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Purpose
Patients with mild to moderate traumatic brain injury (TBI) are at risk for secondary neurological deterioration. Their outcome within the first week after injury could be predicted by clinical signs, brain CT scan and transcranial doppler (TCD) on admission to the emergency room. The investigators aim to evaluate the diagnostic performance of TCD to screen patients presented with mild to moderate TBI and mild lesions on CT scan, i.e., Trauma Coma Data Bank, TCDB classification II. The principal outcome measure is the negative predictive value of TCD.
| Condition | Intervention |
|---|---|
|
Traumatic Brain Injury |
Device: Transcranial Doppler |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Prospective, Multicentre, Observational Study |
- Negative predictive value of transcranial doppler [ Time Frame: within the first week after the injury ] [ Designated as safety issue: Yes ]
Patient with mild to moderate traumatic brain injury (Glasgow Coma Scale 9-15) and a CT scan (TCDB II).TCD is performed within 8 hours after the trauma.
Aggravation defined by:
- a decrease in the Glasgow Coma Scale of 2 points or more from the initial value, in the absence of pharmacological sedation.
- a neurological deterioration sufficient to warrant intervention: mechanical ventilation, sedation, osmotherapy, barbiturates, transfer to more intensive care, or neurosurgical intervention.
- the impact of transcranial doppler for initial patient management [ Time Frame: within the first week after trauma ] [ Designated as safety issue: No ]
Number of brain CTscan performed within 7 days after the trauma.
Number of devices inserted to monitor intracranial pressure.
Secondary admissions to intensive care unit.
Length of hospital stay.
- Secondary neurological aggravation: risk factors and consequences. [ Time Frame: neurological outcome on D7 and D28 ] [ Designated as safety issue: No ]
Neurological outcome on day 7 and day 28 after trauma, as measured with disability rating scale.
Number and type of interventions for neurological deterioration
| Estimated Enrollment: | 360 |
| Study Start Date: | February 2011 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | September 2013 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
Mild TBI with mild lesions on CT scan
Negative predictive value of transcranial doppler for patients with mild to moderate traumatic brain injury and mild brain lesions on initial CT scan (TCDB II)
|
Device: Transcranial Doppler
Negative predictive value of transcranial doppler in patients with mild to moderate traumatic brain injury
|
Eligibility| Ages Eligible for Study: | 15 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Primary admission of patients following mild to moderate traumatic brain injury who need exploration with brain CT scan.
Criteria for inclusion:
- 15 years of age or more
- primary admission for mild TBI (GCS 14-15) or moderate (GCS 9-13) TBI.
- with or without multiple injury.
- with no hemodynamic or respiratory distress: SAP >90mmHg, SPO2 >92%,hemoglobin > 8 g/dl.
- with mild brain lesions on CTscan according to the traumatic coma data bank classification (TCDB) II: diffuse injury with cisterns present and no midline shift, mixed density lesions <25 ml.
- Transcranial Doppler within 8 hours after the trauma.
- patient affiliated to the social security system or equivalent
Criteria for exclusion:
- Severe TBI (GCS<9)
- Penetrating TBI
- patient with no brain CT scan
- patient with normal brain CT scan (TCDB I), or severe brain CT scan (TCDB III-IV)
- Hemodynamic or respiratory distress
- Patient treated with anticoagulants: oral anticoagulant, heparin, anti-platelet agent (except Aspirin)
- previous intracranial surgery
- Patient with sedation and mechanical ventilation
- transcranial Doppler unable
- patient deprived of freedom by judicial or administrative decision
- Follow up at 7 days impossible
- Refusal consent to use data for statistics
Contacts and Locations| Contact: Jean Francois PAYEN, MD | 33 4 76 76 56 35 | JFPayen@chu-grenoble.fr |
| Contact: Carole Rolland | 33 4 76 76 50 40 | CarRolland@chu-grenoble.fr |
| France | |
| CHU Grenoble | Recruiting |
| Grenoble, Isere, France, 38043 | |
| Sub-Investigator: Christophe ROUX, MD | |
| Sub-Investigator: Julien BRUN, MD | |
| Principal Investigator: Pierre BOUZAT, MD | |
| Sub-Investigator: Philippe DECLETY, MD | |
| Sub-Investigator: Affif KADOUR, MD | |
| Sub-Investigator: Laurence SANDERS, MD | |
| Sub-Investigator: Jean Francois PAYEN, MD | |
| Sub-Investigator: Luc ALMERAS | |
| CHRA Annecy | Recruiting |
| Annecy, Rhone Alpes, France, 74000 | |
| Principal Investigator: Albrice LEVRAT, MD | |
| Sub-Investigator: Renaud CHOUQUER, MD | |
| Ch Belley | Not yet recruiting |
| Belley, France | |
| Principal Investigator: Christophe RENARD, MD | |
| CHU | Recruiting |
| Besancon, France | |
| Principal Investigator: Marc GINET, MD | |
| Ch Briancon | Recruiting |
| Briancon, France | |
| Principal Investigator: Olivier BRIOT, MD | |
| Ch Cannes | Not yet recruiting |
| Cannes, France | |
| Principal Investigator: Djamel LAMECHE, MD | |
| Ch Chambery | Recruiting |
| Chambery, France | |
| Principal Investigator: Jean Marc THOURET, MD | |
| Sub-Investigator: Bernard ZERR, MD | |
| Sub-Investigator: Philippe BARBE, MD | |
| Sub-Investigator: Catherine CHASTAGNER, MD | |
| Sub-Investigator: Michel BADET, MD | |
| Sub-Investigator: Alexis SIMOND, MD | |
| Sub-Investigator: Matteo MIQUET, MD | |
| Sub-Investigator: Stephanie MAISON, MD | |
| Sub-Investigator: Stephane BARRE, MD | |
| CHU | Recruiting |
| Clermont Ferrand, France | |
| Principal Investigator: Thierry GILLART, MD | |
| Sub-Investigator: Dominique GUELON, MD | |
| Sub-Investigator: Michele BONNARD GOUGEON, MD | |
| Sub-Investigator: Russel CHABANNE, MD | |
| Sub-Investigator: Francois LONGERAS, MD | |
| CHU | Recruiting |
| Dijon, France | |
| Principal Investigator: Marc FREYSZ, MD | |
| Sub-Investigator: Didier HONNARD, MD | |
| Sub-Investigator: Aurelie GLOAGUEN, MD | |
| Sub-Investigator: Christophe SCHAEFER, MD | |
| Sub-Investigator: Sonia REGAD, MD | |
| Ch Grasse | Recruiting |
| Grasse, France | |
| Principal Investigator: Hichem CHENAITIA, MD | |
| CHU Pierre Benite | Recruiting |
| Lyon, France | |
| Principal Investigator: Jean Stephane DAVID, MD | |
| Chu Edouard Herriot | Not yet recruiting |
| Lyon, France | |
| Principal Investigator: Alexandre VULLIEZ, MD | |
| CHU Lyon | Recruiting |
| Lyon, France | |
| Principal Investigator: Etienne HAUTIN, MD | |
| CH Nantes | Recruiting |
| Nantes, France | |
| Principal Investigator: Karim ASEHNOUNE, MD | |
| Sub-Investigator: Jerome PAULUS, MD | |
| Sub-Investigator: Philippe PES, MD | |
| Chu Nimes | Recruiting |
| Nimes, France | |
| Principal Investigator: Xavier BOBBIA, MD | |
| Ch Saint Jean de Maurienne | Recruiting |
| Saint Jean de Maurienne, France | |
| Principal Investigator: Francois ALBASINI, MD | |
| Hopitaux Du Pays Du Mont Blanc | Recruiting |
| Sallanches, France | |
| Principal Investigator: Carron SCRIMGEOUR, MD | |
| Ch Saint Julien En Genevois | Not yet recruiting |
| St Julien En Genevois, France | |
| Principal Investigator: Cedric LUTZ, MD | |
| Ch Thonon Les Bains | Not yet recruiting |
| Thonon Les Bains, France | |
| Principal Investigator: Marine TASLE, MD | |
| CH Valence | Not yet recruiting |
| Valence, France | |
| Principal Investigator: Philippe BRUGE, MD | |
| Ch Voiron | Recruiting |
| Voiron, France | |
| Principal Investigator: Stephane FRENEA, MD | |
| Ch Voiron | Recruiting |
| Voiron, France | |
| Principal Investigator: Jerome NORMAND, MD | |
| Principal Investigator: | Jean Francois Payen, MD | CHU Grenoble |
More Information
Additional Information:
Publications:
| Responsible Party: | University Hospital, Grenoble |
| ClinicalTrials.gov Identifier: | NCT01291706 History of Changes |
| Other Study ID Numbers: | DCIC 10 17 |
| Study First Received: | February 7, 2011 |
| Last Updated: | March 11, 2013 |
| Health Authority: | France: Comité consultatif sur le traitement de l'information en matière de recherche dans le domaine de la santé |
Keywords provided by University Hospital, Grenoble:
|
Transcranial Doppler Mild and moderate Traumatic Brain Injury Neurological deterioration Brain CT scan |
Additional relevant MeSH terms:
|
Brain Injuries Brain Diseases Central Nervous System Diseases Nervous System Diseases |
Craniocerebral Trauma Trauma, Nervous System Wounds and Injuries |
ClinicalTrials.gov processed this record on May 16, 2013