A Novel Non-invasive Technique of Cerebral Compliance and Auto-regulation Assessment
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|ClinicalTrials.gov Identifier: NCT03144219|
Recruitment Status : Recruiting
First Posted : May 8, 2017
Last Update Posted : July 23, 2019
Introduction: Intracranial pressure (ICP) monitoring is essential in several medical situations, however, currently there is an invasive technique, costly, not widely available and sometimes contraindicated. Transcranial Doppler (TCD) pulsatility index (PI) measure can provide indirect information on the cerebrovascular resistance (CVR) augmentation, which is present concomitantly with intracranial hypertension (ICH). The hypothesis that PI measure accurately indicates cerebral compliance impairment (CCI) has been not assessed by large studies currently, and would be of value as a non invasive technique to denote earlier installing of therapeutics to prevent the effects of ICH. Likewise, a novel technique of intracranial compliance assessment by means of an external sensor has been developed, still in need of being prospectively studied.
Objective: The present study aims to assess PI accuracy indicating CCI, and dynamic cerebral auto regulation (dCAR) during internal jugular veins (IJVs) compression observed by both invasive and non-invasive techniques.
Methods: A prospective, observational controlled study, including critical neurological patients with ICP monitoring in normal range (under 20 mmHg). Initially, dCAR is monitored, then, the IJVs are compressed for 60 seconds with ultrasound guidance. We evaluate optic nerve sheath prior to intervention, and dCAR, ICP values, ICP waveforms and PI variation at different times, correlating results.
|Condition or disease||Intervention/treatment|
|Intracranial Hypertension||Diagnostic Test: Transcranial Doppler (TCD) ultrasound monitoring Diagnostic Test: Non invasive intracranial compliance monitoring|
Show Detailed Description
|Study Type :||Observational|
|Estimated Enrollment :||40 participants|
|Official Title:||A Novel Non-invasive Technique of Cerebral Compliance and Auto-regulation Assessment|
|Actual Study Start Date :||May 1, 2017|
|Estimated Primary Completion Date :||July 2020|
|Estimated Study Completion Date :||July 2020|
- Diagnostic Test: Transcranial Doppler (TCD) ultrasound monitoring
TCD monitoring comatose patients in ICU looking for signs of impaired cerebral compliance
- Diagnostic Test: Non invasive intracranial compliance monitoring
A sensor of cardiac beat by beat cranial dilation will be used for monitoring intracranial compliance, in non-invasive fashion.
- Impaired cerebral compliance [ Time Frame: 10 minutes ]Performing ICP and TCD monitoring simultaneously during jugular compression, matching waveform behavior through computer software QL Online
- Impaired cerebral auto-regulation [ Time Frame: 10 minutes ]The same procedure detailed above, matching mean arterial pressure and CBFv in the computer software QL Online
- Non-invasive intracranial compliance monitoring [ Time Frame: 10 minutes ]The same approaches described above, using the non-invasive Brain4Care system concomitantly.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03144219
|Contact: Sergio Brasil, MDMScemail@example.com|
|University of São Paulo||Recruiting|
|São Paulo, Brazil, 06630-060|
|Contact: Sergio Brasil 1136287231|