Safety and efficacy of normobaric oxygenation on rescuing acute intracerebral hemorrhage-mediated brain damage-a protocol of randomized controlled trial

• Published in: Current controlled trials in cardiovascular medicine Vol. 22; no. 1; pp. 93 - 7
• Main Authors: Chen, Zhiying, Ding, Jiayue, Wu, Xiaoqin, Bao, Bing, Cao, Xianming, Wu, Xiangbin, Yin, Xiaoping, Meng, Ran
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26-01-2021; BioMed Central; BMC
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers; Blood; Brain damage; Brain Edema - diagnosis; Brain Edema - etiology; Brain Edema - therapy; Brain Injuries - diagnosis; Brain Injuries - etiology; Brain Injuries - therapy; Care and treatment; Cerebral Cortex - diagnostic imaging; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - diagnosis; Cerebral Hemorrhage - therapy; Cerebral perfusion; Clinical outcomes; Clinical trials; Edema; Female; Follow-Up Studies; Hematoma; Hospitals; Humans; Hypoxia; Informed consent; Intracerebral hemorrhage; Laboratories; Magnetic Resonance Imaging; Male; Masks; Metabolism; Middle Aged; Normobaric hyperoxia; Oxygen - administration & dosage; Oxygen - adverse effects; Oxygen Inhalation Therapy - adverse effects; Oxygen Inhalation Therapy - instrumentation; Oxygen Inhalation Therapy - methods; Oxygen therapy; Patients; Performance evaluation; Perfusion Imaging - methods; Randomized controlled trial; Randomized Controlled Trials as Topic; Stroke; Study Protocol; Testing; Tomography, X-Ray Computed; Treatment Outcome; Young Adult; China; Normobaric hyperoxia; Cerebral perfusion; Randomized controlled trial; Intracerebral hemorrhage
• ISSN: 1745-6215; 1745-6215
• DOI: 10.1186/s13063-021-05048-4

All of the existing medication and surgical therapies currently cannot completely inhibit intracerebral hemorrhage (ICH)-mediated brain damage, resulting in disability in different degrees in the involved patients. Normobaric oxygenation (NBO) was reported attenuating ischemic brain injury. Herein, we aimed to explore the safety and efficacy of NBO on rescuing the damaged brain tissues secondary to acute ICH, especially those in the perihematoma area being threatened by ischemia and hypoxia.
A total of 150 patients confirmed as acute spontaneous ICH by computed tomography (CT) within 6 h after symptoms onset, will enroll in this study after signing the informed consent, and enter into the NBO group or control group randomly according to a random number. In the NBO group, patients will inhale high-flow oxygen (8 L/min, 1 h each time for 6 cycles daily) and intake low-flow oxygen (2 L/min) in intermittent periods by mask for a total of 7 days. While in the control group, patients will breathe in only low-flow oxygen (2 L/min) by mask for 7 consecutive days. Computed tomography and perfusion (CT/CTP) will be used to evaluate cerebral perfusion status and brain edema. CT and CTP maps in the two groups at baseline and day 7 and 14 after NBO or low-flow oxygen control will be compared. The primary endpoint is mRS at both Day14 post-ICH and the end of the 3rd month follow-up. The secondary endpoints include NIHSS and plasma biomarkers at baseline and Day-1, 7, and 14 after treatment, as well as the NIHSS at the end of the 3rd month post-ICH and the incidence of bleeding recurrence and the mortalities within 3 months post-ICH.
This study will provide preliminary clinical evidence about the safety and efficacy of NBO on correcting acute ICH and explore some mechanisms accordingly, to offer reference for larger clinical trials in the future.
ClinicalTrials.gov NCT04144868 . Retrospectively registered on October 29, 2019.