The Prediction of Intracranial Pressure and Clinical Outcome by Transcranial Doppler in Neurocritical Patients

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Brief Title

The Prediction of Intracranial Pressure and Clinical Outcome by Transcranial Doppler in Neurocritical Patients

Official Title

The Prediction of Intracranial Pressure and Clinical Outcome by Transcranial Doppler in Neurocritical Patients

Brief Summary

      The purpose of this study is to use transcranial Doppler (TCD) to predict intracranial
      pressure (ICP) and clinical outcome of neurocritical patients.
    

Detailed Description

      Transcranial Doppler (TCD) and Transcranial color-coded duplex sonography (TCCS) play an
      important part in neurocritical monitoring systems. Currently there are studies using flow
      velocities and pulsatility index (PI) to predict intracranial pressure (ICP) and clinical
      outcome. But the use of B-mode in such prediction is not yet investigated. The purposes of
      this study are to establish the correlation among clinical data, CT findings and information
      collected by TCCS, and to predict ICP and neurological outcome using such information. The
      focus would be on 3rd ventricle size, midline shift and anteroposterior-transverse ration of
      midbrain (midbrain index) obtained by B-mode of TCCS. This study is a prospective clinical
      study targeting on 30 neurocritical patients admitted to intensive care units in one year.
      The timing of performance of TCCS will be (1) within 6 hours after admission, (2) within 6
      hours after each CT examination, and (3) when ICP is higher than 20 mmHg for more than 5
      minutes. Glasgow coma scale (GCS), heart rate, blood pressure (systolic, diastolic, and
      mean), body temperature, central venous pressure (CVP), brain temperature, ICP, cerebral
      perfusion pressure (CPP), mean velocity (MV) of bilateral middle cerebral arteries (MCAs),
      PI, midline shift, 3rd ventricular dimension, anteroposterior to transverse ratio of midbrain
      (midbrain index, MI) are recorded. The latter three parameters are also obtained from CT
      scans, and compared with those obtained from TCCS. Outcome is evaluated with extended Glasgow
      outcome scale (GOSE), and analyzed with previous records. This study is going to prove that
      TCCS is a safe, convenient, real-time and cheap tool in clinical care for neurocritical
      patients. It also provides prediction of ICP and clinical outcome.
    


Study Type

Observational




Condition

Head Injury


Study Arms / Comparison Groups

 Neurocritical patients
Description:  Neurocritical patients including those sustaining head injury, cerebrovascular events (such as intracerebral hemorrhage, subarachnoid hemorrhage, etc.), brain tumor, or hydrocephalus.

Publications

* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information



Estimated Enrollment

30

Start Date

December 2009

Completion Date

December 2010

Primary Completion Date

December 2010

Eligibility Criteria

        Inclusion Criteria:

          -  Aged 16 to 80 years

          -  Neurocritical patient (head injury, hemorrhagic or ischemic stroke, subarachnoid
             hemorrhage, etc.) who was admitted to intensive care unit and had undergone
             intracranial pressure monitoring

        Exclusion Criteria:

          -  associated with multiple organ impairment or failure

          -  single organ failure prior to neurocritical condition, such as cardiac, hepatic, or
             renal failure

          -  associated with severe infection or sepsis
      

Gender

All

Ages

16 Years - 80 Years

Accepts Healthy Volunteers

No

Contacts

Yi-Hsin Tsai, M.D., , 

Location Countries

Taiwan

Location Countries

Taiwan

Administrative Informations


NCT ID

NCT00886054

Organization ID

200901010R

Secondary IDs

97WFA0102463


Study Sponsor

National Taiwan University Hospital

Collaborators

 National Science Council, Taiwan

Study Sponsor

Yi-Hsin Tsai, M.D., Principal Investigator, Department of Traumatology, National Taiwan University Hospital


Verification Date

December 2009