Traumatic Brain Injury
Conditions
Keywords
Traumatic brain injury, Myocardial dysfunction, Transthoracic echocardiography, Speckle tracking
Brief summary
Traumatic brain injury (TBI) is a frequent pathology leading to major morbidity and mortality in young people. Cerebral flood flow maintenance is a major goal directed therapy to improve the prognosis of the patient. Due to cerebral-myocardial interaction, a myocardial dysfunction might occur at the early phase of the traumatic brain injury. This myocardial dysfunction could be partly responsible for a decrease in cerebral blood flow. In such case, improving myocardial dysfunction may help to increase cerebral blood flow and improve patient prognosis. In clinical practice the easiest and non invasive way to explore myocardial dysfunction is with transthoracic echocardiography. The objective of this trial is to investigate myocardial dysfunction at the early phase of traumatic brain injury, compared with a controlled group without TBI.
Interventions
OTHERTransthoracic echocardiography on TBI patients
Two Dimensional and speckle trackingTransthoracic echocardiography on TBI patients within 24 hours of trauma
OTHERTransthoracic echocardiography on control patients
Two Dimensional and speckle trackingTransthoracic echocardiography on control patients while intubated-ventilated
Sponsors
University Hospital, Grenoble
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
TBI patients Inclusion Criteria: * Isolated and non opened traumatic brain injury * 18 - 65 years old * Intubated and mechanically ventilated * Glasgow score \< or = 9 or * Glasgow score between 9 and 13 (included) and Following Traumatic Coma Data Bank Tomographic Damages diffuse injuries type III or IV or mass lesion over 25ml and/or neurosurgical injuries * Medical insurance
Exclusion criteria
* Treated major cardiovascular risks factors * cardiovascular past medical history (acute cardiovascular event) * Cardio thoracic surgery * Brain dead status * Inotrope drugs * Severe polytraumatism * Acute haemorrhage * Non echogenic patient * High level athlete * Incapacitated person by law and pregnant women * Discovery during echocardiography of underlying cardiomyopathy * Urgent neurosurgery required Control patients Inclusion Criteria: * Isolated and non opened traumatic brain injury * 18 - 65 years old * Intubated and mechanically ventilated * Paired with TBI patient on age, BMI and sex * Undergoing urgent non severe surgery * Medical insurance
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| left ventricular ejection fraction | within the first 24 hours after injury |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Systolic twisting velocity by speckle tracking (in degree by second) | within the first 24 hours after injury | — |
| Strain evaluation by speckle tracking (in percentage of systolic duration) | within the first 24 hours after injury | — |
| Systolic strain rate by speckle tracking (in second) | within the first 24 hours after injury | — |
| Diastolic strain rate by speckle tracking (in second) | within the first 24 hours after injury | — |
| Systolic rotational velocity by speckle tracking (in degree by second) | within the first 24 hours after injury | — |
| Diastolic untwisting velocity by speckle tracking (in degree by second) | within the first 24 hours after injury | — |
| Diastolic rotational velocity by speckle tracking (in degree by second) | within the first 24 hours after injury | — |
| left ventricular diastolic function (cm/sec) | within the first 24 hours after injury | 2D transthoracic echography |
| Cardiac index | within the first 24 hours after injury | 2D transthoracic echography |
| tissue doppler imaging (cm/sec) | within the first 24 hours after injury | 2D transthoracic echography |
| right ventricular diastolic function | within the first 24 hours after injury | 2D transthoracic echography |
| right ventricular systolic function | within the first 24 hours after injury | 2D transthoracic echography |
| Myocardial wall thickness (in millimeter) | within the first 24 hours after injury | 2D transthoracic echography |
Countries
France
Outcome results
None listed