Health Condition 1: S064- Epidural hemorrhage Health Condition 2: S063- Focal traumatic brain injury Health Condition 3: S020- Fracture of vault of skull Health Condition 4: S018- Open wound of other parts of head Health Condition 5: S068- Other specified intracranial injuries Health Condition 6: S066- Traumatic subarachnoid hemorrhage Health Condition 7: S065- Traumatic subdural hemorrhage
Conditions
Interventions
Intervention1: NIL: NIL
Sponsors
NIMHANS
Eligibility
Inclusion criteria
Inclusion criteria: All adult patients (18 - 75 years of age), with moderate to severe TBI admitted to Neuro ICU/ward within 48 hours of injury
Exclusion criteria
Exclusion criteria: 1. Absence of feasibility of performing Quantitative Pupillometry(QP) and ONSD assessment on the eye contralateral to the side with significant TBI (contralateral eye with pupillary disease or significant periorbital oedema where pupillary assessment is not possible) 2. Patients for whom consent is not available 3. Patients with significant co-morbidities/ extra cranial injuries where these are likely to affect survival
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Association between the magnitude of change in QPi (amplitude of photomotor reflex) to noxious stimulation assessed in the contralateral pupil (opposite to injured side) using automated pupillometry and neurological outcome assessed using Glasgow Outcome Scale Extended (GOSE)Timepoint: 1. at discharge 2. at 3 months | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Association between pupillary parameters other than QPi [pupillary diameter (PD), change in pupil diameter (measured as % variation), latency, constriction velocity (CV)] assessed using automated pupillometer during noxious stimulation, and neurological outcome assessed using m-GCS at hospital discharge, in-hospital mortality and GOSE after TBI in ICU and ward patients 2. Association between anisocoria and neurological outcome assessed using m-GCS at hospital discharge, in-hospital mortality and GOSETimepoint: 1. At 3 months 2. At 6 months;3.To determine the correlation between nurse assessed pupillary diameter before light reflex and baseline pupil diameter assessed with automated pupillometer in ICU 4. To assess the effect of opioid (if administered as part of sedoanalgesia) on QPi in ICU Timepoint: At initial assessment after admission to ICU within 48 hours of injury;5.To evaluate the correlation between BPS and pupillary parameters after TBI during noxious stimulations such as tracheal suctioning and supraorbital pressure in ICU 6.To determine correlation of ONSD with QPi response to noxious stimuli in ICU 7.To determine correlation of change in depth of consciousness assessed on forehead contralateral to the injured side/ less injured side assessed using Bispectral Index (BIS) and hemodynamic parameters – heart rate and mean arterial pressure with the change in QPi in response to noxious stimuli in ICU Timepoint: At 12 hour intervals for 3 days or till discharge after admission to ICU/ward post surgery whichever is earlier | — |
Countries
India
Contacts
Public ContactDeeparaj L
NATIONAL INSTITUTE OF MENTAL HEALTH AND NEUROSCIENCES, Bangalore
Outcome results
None listed