Controlled MAP in the Brain Injury Patient (COMAT Study)

NCT ID: NCT03991052

Last Updated: 2023-05-30

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

NA

Total Enrollment

23 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-18

Study Completion Date

2021-07-07

Brief Summary

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The goal of this randomized controlled trial will be to show that the use of a novel automated system to guide vasopressor administration in brain injury patients will results in more time spent with a mean arterial pressure (MAP) within the predefined MAP (+/- 5 mmHg of the target MAP) compared to patients managed without any automated system (manually management)

Detailed Description

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In brain injury patients, the maintenance of MAP within a very narrow range is desired to avoid complications related to hypoperfusion (undertreatment) or hypertension (over treatment). However, the MAP needed to reach can vary over time based on intracranial pressure. Additionally, it is well know that the nurses in the Intensive care unit managed multiple patients simultaneously and cannot dedicate 100% of his-her time to adjust drugs infusions. Using a novel automated system can overcome this issue and may lead to more time in MAP target (+/- 5mmHg) than the traditional management.

After initial rescuscitation of the patients, patients in both groups will have the same baseline maintenance fluid administration of 1-2 ml/kg/h of crystalloid solution and additionnal fluid boluses administered following the EV1000 monitoring device. The only difference will be the management of vasopressor titration (manual by nurses vs automated via a closed-loop system)

Conditions

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Brain Injuries

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

manual versus automated management of MAP
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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EV1000 monitor

MAP management will be done as usual (adjustment by nurses) and fluid management will be managed using the EV1000 monitoring device with the automated decision support system

Group Type ACTIVE_COMPARATOR

Control group

Intervention Type DEVICE

This system will recommend when patients need fluid or not and nurses will adjust vasopressor administration as usual (standard of care)

EV1000 monitor + closed-loop system

Fluid management will be done using the automated decision support system and MAP will be adjusted by the automated closed-loop system for vasopressor administration

Group Type EXPERIMENTAL

EV1000 and closed-loop system

Intervention Type DEVICE

This system will recommend when patients need fluid or not and adjust vasopressor administration automatically by the closed-loop system

Interventions

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EV1000 and closed-loop system

This system will recommend when patients need fluid or not and adjust vasopressor administration automatically by the closed-loop system

Intervention Type DEVICE

Control group

This system will recommend when patients need fluid or not and nurses will adjust vasopressor administration as usual (standard of care)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* severe brain injury patients (Glasgow score \<9), intubated, ventilated and sedated.

Exclusion Criteria

* Glasgow score \> 8
* Bilateral mydriasis at the initial management (Ambulance and first hour of arrival)
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of California, Los Angeles

OTHER

Sponsor Role collaborator

University of California, Irvine

OTHER

Sponsor Role collaborator

Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jacques DURANTEAU, MD, PhD

Role: STUDY_CHAIR

Bicetre

Locations

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Bicêtre hospital

Le Kremlin-Bicêtre, , France

Site Status

Countries

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France

Other Identifiers

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APHP180501

Identifier Type: -

Identifier Source: org_study_id

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