Acute Brain Injury
Conditions
Keywords
Acute brain injury, Intensive care, Neurointensive care, Anaesthesiology, Multimodal neuromonitoring, Glucose, Hyperglycaemic clamp
Brief summary
Acute brain injury is a serious condition that often results in admission to an intensive care unit. Some of the most seriously ill patients are fitted with multimodal neuromonitoring, a newer monitoring modality that can, among other things, measure oxygen tension and sugar levels in brain tissue. It is common clinical practice, but the interaction between the body's sugar levels and the brain's sugar levels is not sufficiently elucidated. The study will investigate the relationship between the body's sugar levels, measured in arterial and venous blood, and the brain's sugar level, measured by microdialysis, in patients with severe acute brain injury. Furthermore, we hope to be able to use our measurements to set up a mathematical model for the brain's sugar uptake.
Interventions
OTHERHyperglycaemic clamp
Following an overnight fast, the investigators will perform simultaneous samples from the arterial line, the venous line, and microdialysis and consider these samples as baseline values. If the patient's blood glucose level is at 8-10 mmol/L at baseline, the investigators will not proceed with the intervention and instead evaluate if the intervention can take place the following day. After baseline values are measured, intravenous glucose 20% (200g/1,000 ml) is infused to raise the glucose levels in both plasma and extravascular glucose compartments with approximately 3 mmol/L.
Sponsors
Rigshospitalet, Denmark
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
14 patients, all will have an hyperglycaemic clamp performed during admission while measuring cerebral microdialysis
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years. * Admission to the neuro-ICU at Rigshospitalet. * Multimodal neuromonitoring
Exclusion criteria
* Closest relative does not understand written and spoken Danish or English. * Patients with known diabetes mellitus upon admission.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| (Change in) MD-glucose (mmol/L) | Throughout the intervention, approximately five hours | Change in) MD-glucose (mmol/L) over time as a function of (a set change in) arterial blood glucose (mmol/L) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Jugular vein glucose (mmol/L) over time as a function of arterial blood glucose. | Throughout the intervention, approximately five hours | Jugular vein glucose (mmol/L) over time as a function of arterial blood glucose (mmol/L) |
| Lactate-pyruvate-ratio (LP-ratio) as a function of arterial blood glucose. | Throughout the intervention, approximately five hours. | Two other microdialysis paramethers, lactate and pyruvat, will be assessed to evaluate the lactate-pyruvate ratio over time as a function of arteriel blood glucose. |
Countries
Denmark
Outcome results
None listed