Early Propranolol After Traumatic Brain Injury: Phase II
| Status: | Terminated |
|---|---|
| Conditions: | Hospital, Neurology |
| Therapuetic Areas: | Neurology, Other |
| Healthy: | No |
| Age Range: | 18 - 100 |
| Updated: | 5/14/2016 |
| Start Date: | June 2010 |
| End Date: | February 2015 |
A Phase II, Dose Escalation, Single Center Study on the Effects of Early Propranolol on Heart Rate, Blood Pressure, and Cerebral Perfusion Pressure in Subjects Who Present With Moderate to Severe Traumatic Brain Injury.
The primary objective of this study is to determine in patients with traumatic brain injury
(TBI) the safe dosing of propranolol. Safety will be measured by episodes of bradycardia
(heart rate < 60 beats per minute), hypotension (defined as systolic blood pressure < 90) or
decreased cerebral perfusion pressure (defined as CPP less than 60mmHg) that are refractive
to Brain Trauma Foundation guidelines for treatment. A no-treatment arm will establish the
number of episodes of bradycardia, hypotension and reduced cerebral pressure refractory to
treatment that occur without propranolol.
(TBI) the safe dosing of propranolol. Safety will be measured by episodes of bradycardia
(heart rate < 60 beats per minute), hypotension (defined as systolic blood pressure < 90) or
decreased cerebral perfusion pressure (defined as CPP less than 60mmHg) that are refractive
to Brain Trauma Foundation guidelines for treatment. A no-treatment arm will establish the
number of episodes of bradycardia, hypotension and reduced cerebral pressure refractory to
treatment that occur without propranolol.
Inclusion Criteria:
- patients who present within 6 hours of traumatic brain injury who have 1) a Glasgow
Coma Scale (GCS) score of ≤8 or a GCS of 9-12 with computerized tomography brain
scans demonstrating brain injury.
Exclusion Criteria:
- pregnancy,
- patients already treated with beta-blockers,
- patients treated for antiarrhythmic, immunosuppressive or antiinfective treatment,
- myocardial infarction during the last 3 months,
- unstable or severe heart disease,
- severe chronic obstructive pulmonary disease,
- serious liver disease,
- cardiac ischemia that prevents the initiation of vasopressors,
- signs of cardiac arrhythmia or heart block on EKG,
- ischemic limb disease that prevents the initiation of vasopressors, vasopressors at
maximum dose defined as norepinephrine at 40µg/min or neosynephrine at 300µg/min.
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