Optimized Therapy in Severe Traumatic Brain Injured Patients

NCT ID: NCT02130674

Last Updated: 2014-05-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-01-31

Study Completion Date

2011-02-28

Brief Summary

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Severe traumatic brain injury is associated with life-threatening and incapacitating secondary injury.

Contemporary therapeutic interventions are aimed at preventing and treating secondary damage. In this context, improved cerebral metabolism is an important target in modern neurointensive care.

The main hypothesis is that continuous intravenous infusion of glutamyl-alanyl dipeptide restores disturbed brain metabolism following severe traumatic brain injury.

Detailed Description

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Patients suffering from severe traumatic brain injury and requiring multimodal neuromonitoring during pharmacological coma will receive alanyl-glutamine dipeptide (Dipeptiven) as part of standard clinical nutrition.

In two groups of patients the influence of different duration of infusion (group 1: 24 hours; group 2: 5 days) will be investigated. For this, pharmacokinetic and pharmacodynamic parameters in plasma and brain are determined.

Increased plasma glutamine and alanine in arterial and jugular venous plasma and in cerebral microdialysates are to reflect efficacy of Dipeptiven infusion.

Plasma glutamate levels as well as changes in cerebral glutamate, lactate, lactate/pyruvate ratio, intracranial pressure, bispectral index electroencephalography will be measured to exclude potential adverse effects

Conditions

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Traumatic Brain Injury Coma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dipeptiven

0.75 g/ kg/ d Dipeptiven ( L- alanine- L- glutamine; 82 mg/ ml L- alanine, 134.6 mg/ ml L- glutamine; Fresenius Kabi, Switzerland) continuous intravenous infusion

Group Type EXPERIMENTAL

Dipeptiven

Intervention Type DRUG

two groups: group 1: continuous infusion for 24 hours group 2: continuous infusion for 5 days

Interventions

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Dipeptiven

two groups: group 1: continuous infusion for 24 hours group 2: continuous infusion for 5 days

Intervention Type DRUG

Other Intervention Names

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Dipeptamin

Eligibility Criteria

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Inclusion Criteria

* severe traumatic brain injury
* prolonged pharmacologic coma
* multimodal neuromonitoring (microdialysis, ptiO2)
* enteral nutrition

Exclusion Criteria

* patients anticipated to decease within 48 hours
* abdominal injury
* mass transfusion
* renal impairment
* hepatic impairment
* barbiturate coma
* parenteral nutrition
* weight below 50 kg
* weight above 100 kg
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Swiss National Science Foundation

OTHER

Sponsor Role collaborator

Fresenius Kabi

INDUSTRY

Sponsor Role collaborator

University Hospital, Zürich

OTHER

Sponsor Role collaborator

University of Zurich

OTHER

Sponsor Role lead

Responsible Party

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John Stover

Prof. Dr. med.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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John F Stover, MD

Role: PRINCIPAL_INVESTIGATOR

University of Zurich

Locations

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University Hospital Zurich

Zurich, , Switzerland

Site Status

Countries

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Switzerland

References

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Nageli M, Fasshauer M, Sommerfeld J, Fendel A, Brandi G, Stover JF. Prolonged continuous intravenous infusion of the dipeptide L-alanine- L-glutamine significantly increases plasma glutamine and alanine without elevating brain glutamate in patients with severe traumatic brain injury. Crit Care. 2014 Jul 2;18(4):R139. doi: 10.1186/cc13962.

Reference Type DERIVED
PMID: 24992948 (View on PubMed)

Other Identifiers

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SNF 111782

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

SNF 111782

Identifier Type: -

Identifier Source: org_study_id

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