RECRUITING

External Lumbar Drainage to Reduce ICP in Severe TBI: a Phase 1 Clinical Trial

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

The goal of this phase 1 randomized controlled safety and feasibility clinical trial are to determine the safety of external lumbar drainage (ELD) in select patients with severe Traumatic Brain Injury (TBI). The main questions it aims to answer are (i) if ELD is feasible and (ii) safe to perform in severe TBI patients who have radiological evidence of patent basal cisterns and midline shift \<5mm without increasing the risk of neurological worsening or cerebral herniation. All participants will receive routine usual care. The study group will additionally have ELD for cerebrospinal fluid (CSF) drainage. A comparison will be made between the usual treatment plus ELD (interventional) groups, and the usual treatment (control) groups on incidence rate of neurological worsening or cerebral herniation events, and whether total hours with raised intracranial pressure (ICP) are different.

Official Title

External Lumbar Drainage to Abort Severe Traumatic IntraCranial Hypertension: A Phase 1 Randomized, Allocation-concealed, Open-label, Safety and Feasibility Clinical Trial

Quick Facts

Study Start:2024-06-24
Study Completion:2025-06-30
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT05889650

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years to 65 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. 1. 18-65 years age
  2. 2. Glasgow Coma Scale (GCS) 3-8
  3. 3. Pupils symmetric and bilaterally reactive
  4. 4. Midline shift ≤5mm at the level of foramen of Monro on admission or post-operative brain CT
  5. 5. Patent (complete or partial) quadrigeminal cisterns on admission or post-operative brain CT
  6. 6. First randomization and intervention may be commenced within 24 hours of injury
  7. 7. ELD safety score ≥5
  1. 1. GCS \>8
  2. 2. Cisterns on CT completely effaced
  3. 3. Midline shift on CT \>5mm
  4. 4. GCS 3 with dilated and fixed pupils
  5. 5. Uncal or tonsillar herniation on admission or post-operative brain CT
  6. 6. Temporal lobe contusions
  7. 7. Penetrating TBI
  8. 8. Primary hemicraniectomy
  9. 9. Pregnancy
  10. 10. Prisoners
  11. 11. Patients previously lacking capacity to consent or refuse treatment, or with advanced directives to forego aggressive care
  12. 12. Pre-existing conditions affecting functional status or life expectancy to less than 1 year
  13. 13. Contra-indications for ELD placement: coagulopathy, use of anticoagulants or anti-thrombotics, thrombocytopenia \<50,000, or severe spinal deformity.

Contacts and Locations

Study Contact

Carlos Morales, MPH
CONTACT
240-6536638
carlos.morales.ctr@usuhs.edu
Halinder S Mangat, MD, MSc
CONTACT
913-5886970
elastic@braintrauma.org

Principal Investigator

Halinder S Mangat, MD MSc
PRINCIPAL_INVESTIGATOR
Brain Trauma Foundation; Kansas University Medical Center Research Institute
Jamshid Ghajar, MD PhD
PRINCIPAL_INVESTIGATOR
Brain Trauma Foundation
Gregory Hawryluk, MD PhD
PRINCIPAL_INVESTIGATOR
Cleveland Clinic Foundation, Brain Trauma Foundation
Bradley Dengler, MD
STUDY_CHAIR
Military Traumatic Brain Injury Initiative, Uniformed Services University

Study Locations (Sites)

University of Florida
Gainesville, Florida, 32610
United States
Kansas University Medical Center
Kansas City, Kansas, 66160
United States
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
United States
Brooke Army Medical Center
Fort Sam Houston, Texas, 78234
United States
University of Texas
San Antonio, Texas, 78249
United States

Collaborators and Investigators

Sponsor: Brain Trauma Foundation

  • Halinder S Mangat, MD MSc, PRINCIPAL_INVESTIGATOR, Brain Trauma Foundation; Kansas University Medical Center Research Institute
  • Jamshid Ghajar, MD PhD, PRINCIPAL_INVESTIGATOR, Brain Trauma Foundation
  • Gregory Hawryluk, MD PhD, PRINCIPAL_INVESTIGATOR, Cleveland Clinic Foundation, Brain Trauma Foundation
  • Bradley Dengler, MD, STUDY_CHAIR, Military Traumatic Brain Injury Initiative, Uniformed Services University

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2024-06-24
Study Completion Date2025-06-30

Study Record Updates

Study Start Date2024-06-24
Study Completion Date2025-06-30

Terms related to this study

Keywords Provided by Researchers

  • Traumatic brain injury
  • intracranial pressure
  • intracranial hypertension
  • lumbar drainage

Additional Relevant MeSH Terms

  • Severe Traumatic Brain Injury
  • Intracranial Hypertension