Health Condition 1: G00-G99- Diseases of the nervous system
Conditions
Interventions
Intervention1: Nil: Nil
Intervention2: Nil: Nil
Intervention3: Nil: Nil
Intervention4: Nil: Nil
Intervention5: Nil: Nil
Sponsors
All India Institute of Medical Sciences, New Delhi
Eligibility
Inclusion criteria
Inclusion criteria: Patients between the ages of 15 and 75 admitted to the neuro-ICU with severe brain damage of known etiology [aneurysmal subarachnoid hemorrhage (a SAH), traumatic brain injury (TBI), brain tumor, intracerebral hemorrhage (ICH), acute ischemic stroke] and deeply comatose (GCS- 3)
Exclusion criteria
Exclusion criteria: 1.Refusal of consent by a relative. 2.CNS infections as the cause of coma/ Severe sepsis. 3.Severe facial trauma, including forehead scalp hematomas, cranial metal implants. 4.History of raised intra-ocular pressure and eye trauma precluding measurement of QPi and ONSD. 5.Un-evacuated frontal subdural hematoma (SDH). 6.Polytrauma with lung injury and prior history of respiratory disease impeding ventilation and oxygenation. 7.Prior history of cardiovascular disease.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Serial measurements of rSO2, QPi, and ONSD from a state of deep coma till brain death confirmation.Timepoint: Once the patient with GCS of 3 develops FOUR score of 0, a state of IBD will be considered. Neurological and hemodynamic monitoring, NIRS,QPi and ONSD values will be documented every 6th hour until apnea test establishes a confirmatory diagnosis of brain death or neurological recovery occurs. Time to development of IBD and brain death confirmation will be noted. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1.Patient outcome (improved GCS/FOUR Scores or positive apnea test or cardiac death) 2.Time to brain death diagnosis. 3.Time to cardiac death after diagnosis of brain death Timepoint: Once the patient with GCS of 3 develops FOUR score of 0, a state of IBD will be considered. Neurological & hemodynamic monitoring, NIRS, QPi, & ONSD values will be documented every 6th hour until the apnea test establishes a confirmatory diagnosis of brain death or neurological recovery occurs. Time to development of IBD & brain death confirmation will be noted | — |
Countries
India
Contacts
Public ContactDr Girija Parsad Rath
AIIMS New Delhi
Outcome results
None listed