BFBP: Blood Pressure Treatment in ICU Patients With Subarachniodal Haemorrhage.

Sponsor

Umeå University (Other)

Overall Status

Not yet recruiting

CT.gov ID

NCT06033378

Collaborator

Region Västerbotten (Other)

Enrollment

Arm

Anticipated Duration (Months)

Study Details

Study Description

Brief Summary

An MRI study to examine the relationship between blood pressure and cerebral blood flow in patients with subarachnoidal hemorrhage and suspect or verified vasospasm.

Condition or Disease	Intervention/Treatment	Phase
Blood Pressure Subarachnoid Hemorrhage Aneurysm Cerebral	Other: Blood pressure elevation	N/A

Detailed Description

Subarachnoidal hemorrhage (SAH) is a type of stroke with high mortality rates and often requires care at the intensive care unit. Cerebral blood flow (CBF) needs to be ensured so that the brain receives optimal nourishment, and this is largely controlled by regulating blood pressure (BP) using medications that affect the heart and blood vessels. Approximately 3-7 days after SAH onset, vasospasm (SAH-V) can occur. Treatment usually includes maintaining blood pressure (BP) above a certain threshold to achieve adequate cerebral blood flow (CBF). An important component of raising BP is increasing vascular resistance using vasoconstrictive medications, which paradoxically can decrease CBF.

Our objective is to investigate the correlation between BP changes and their impact on CBF in patients with suspect or verified SAH-V using MRO.

To achieve our purpose, we plan to examine the relationship between BP and CBF in patients with SAH-V who require neuro-intensive care. For measuring CBF, we will use MRI with two different MRI techniques: phase-contrast MRI and arterial spin labeling.

Flow measurement with MRI:

Baseline images will be acquired at baseline blood pressure.
Mean arterial pressure (MAP) will be increased using norepinephrine. New images will be acquired when MAP is increased by approximately 20-30% from the baseline.

All BP levels will be maintained within clinically acceptable ranges. All data will be recorded in the patient's medical record, and MRI images will be processed at a later stage.

Study Design

Study Type:

Interventional

Anticipated Enrollment :

30 participants

Allocation:

N/A

Intervention Model:

Single Group Assignment

Masking:

None (Open Label)

Primary Purpose:

Basic Science

Official Title:

Blood Pressure Treatment in ICU Patients With Subarachniodal Haemorrhage. -Can Blood Pressure be Used as a Surrogate Marker for Blood Flow

Anticipated Study Start Date :

Sep 1, 2023

Anticipated Primary Completion Date :

Sep 1, 2025

Anticipated Study Completion Date :

Sep 1, 2025

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Cerebral blood flow Change in cerebral blood flow with increased systemic blood pressure	Other: Blood pressure elevation Increasing systemic blood pressure for measurement of cerebral blood flow changes

Arm

Intervention/Treatment

Experimental: Cerebral blood flow

Change in cerebral blood flow with increased systemic blood pressure

Other: Blood pressure elevation

Increasing systemic blood pressure for measurement of cerebral blood flow changes

Outcome Measures

Primary Outcome Measures

Cerebral blood flow [1 hour]
mL/min as measured by MRI

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Coiled or clipped aneurysm Suspected or confirmed vasospasm

Exclusion Criteria:

BMI >30 Pregnancy Pacemaker or other MRI contraindications Severe congestive heart failure (NYHA III-IV) or cardiac arrhythmia. Severe respiratory failure or FiO2 >0.6 Severe kidney failure