Treatment of Spontaneous Hyperventilation With Remifentanil in Traumatic Brain Injury Patients

• Status: Recruiting
• Trial end date: 2022-03-31
• Target enrollment: 0
• Participant gender: All

Summary

Spontaneous hyperventilation is common in severe traumatic brain injury patients and correlates closely with poor outcomes. How to treat this pathological condition remain unsolved. Remifentanil is a frequently used short-acting opioid, has the potent side-effect of dose-dependent respiratory inhibition. Specifically, it prolongs the expiratory time only and does not influence the respiratory drive. Among the safety range, the investigators will determine an ideal dose of remifentanil to maintain PaCO2 between 35 to 45 mmHg. The investigators will monitor the cerebral blood flow of the middle cerebral artery and the internal carotid artery to validate cerebral perfusion improvement.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Capital Medical University
• Treatments: Remifentanil

Criteria

Inclusion Criteria:

• Age ≥ 18 years

• Severe TBI (3 < glasgow coma scale (GCS) ≤ 8)

• Hyperventilation (PaCO2 < 35 mmHg and pondus hydrogenii (pH) > 7.45)

• Presence of an endotracheal tube

• Assisted ventilation mode (CPAP/PSV)

Exclusion Criteria:

• Induced/iatrogenic hyperventilation

• No informed consent was signed

• Transcranial doppler sonography (TCD) data collection cannot be completed due to anatomical structure

• Severe multiple organ failure, persistent high fever, massive thoraco-peritoneal effusion

• Medical history of major craniocerebral injury and chronic obstructive pulmonary disease (COPD)

• Conformed or Suspected history of opioid-related adverse reactions

• Withdraw from the study due to the change of patient's condition and other methods of treatment and intervention are needed