Name: BOOST3 (Brain Oxygen Optimization in Severe TBI: A Comparative Effectiveness Study to Test the Efficacy of a Prescribed Treatment Protocol Based on Monitoring the Partial Pressure of Brain Tissue Oxygen)
Contact: Dr. Chris Robinson (PI) (304) 646-4613 and Magali Jorand-Fletch (Lead CRC) (352) 294-5391
Enrolling hours: M-F 8-5PM
Diagnosis: TBI
Inclusion:
- Non-penetrating traumatic brain injury
- Requirement for intracranial pressure monitoring, based on BTF/ACS TQIP Guidelines for the management of severe TBI, as operationalized below:
- Glasgow Coma Scale (GCS) 3-8 measured off paralytics (Glasgow Coma Scale motor score < 6 if endotracheally intubated)
- Evidence of intracranial trauma on CT scan
- If patient has a witnessed seizure, wait 30 min to evaluate GCS
- Able to place intracranial monitors and randomize within 6 hours of arrival at enrolling hospital, but no later than 12 hours from injury
- Age greater than or equal to 14 years
Exclusion:
- Bilaterally absent pupillary response in the absence of paralytic medication
- Contraindication to the placement of intracranial probes, such as uncorrectable coagulopathy
- Treatment of brain tissue oxygen values prior to randomization
- Planned use of devices which may unblind treating physicians to brain tissue hypoxia
- Clinical, demographic, or other characteristics that precludes appropriate diagnosis, treatment, or follow-up
- Systemic sepsis at screening
- Refractory hypotension (SBP< 90 mmHg for two consecutive readings at least 15 minutes apart any time prior to randomization)
- Refractory systemic hypoxia (SaO2 < 90% or FIO2 >0.5 for two consecutive readings at least 15 minutes apart any time prior to randomization)
- PaO2/FiO2 ratio < 150
- Known pre-existing neurologic disease with confounding residual neurological deficits
- Known inability to perform activities of daily living (ADL) without assistance prior to injury
- Known active drug or alcohol dependence that, in the opinion of site investigator, would interfere with physiological response to brain tissue oxygen treatments
- Non- survivable injury
- Pregnancy
- Prisoner or ward of the state
- Patient listed on EFIC opt-out registry for study