JUgular Gating for Upright Level Adjustment and Targeted Enhancement of Cerebral Perfusion
Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorUniversity Hospital, Bordeaux
About this trial
Investigators aim to demonstrate that the evolution of intracranial pressure (ICP) is nonlinear and may be influenced by jugular vein collapse. This collapse is estimated to occur at the angle where the hydrostatic pressure of the blood column matches the central venous pressure, and it can be assessed using ultrasonography. This approach allows for the determination of an individualized tilt angle, optimizing cerebral perfusion pressure without compromising venous drainage.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Patients ≥ 18 years old
Hospitalized in the neurocritical care unit or the trauma unit
Scheduled for nursing care requiring a supine position.
Arterial catheter allowing continuous measurement of mean arterial pressure.
Disqualifiers
Contraindication to trunk mobilization.
Being a minor or placed under supervision.
Hemodynamic or respiratory instability.
Uncontrolled intracranial hypertension, refractory arterial hypertension, or severe dysautonomia.
Trial population
Patient hospitalized in the neurocritical care unit or the trauma unit
Trial design
Design model
Case-control
Time perspective
Prospective
Treatments tested in this trial
Ultrasound assessment
Procedure/SurgeryAfter the routine nursing care, during patient repositioning to 30 ° assessments are performed at 0, 10° 20° 30°, and at a calculated threshold angle α. At each angle intracranial pressure , cerebral perfusion pressure and ultrasound assessment of cerebral blood flow velocities and internal jugular vein cross-sectional area at three cervical levels are recorded.
Treatment groups
30 Participants
are divided into 1 treatment groupGroup A: Experimental group1 intervention
Trial outcomes
Primary outcomes
1
Intracranial pressure
After the routine nursing care, during patient repositioning to 30 ° assessments are performed at 0, 10° 20° 30°, and at a calculated threshold angle α. At each angle intracranial pressure is recorded.
Time frame
At inclusion (day 0)Secondary outcomes
1
Cerebral perfusion pressure at 30° and at angle α (1)
Comparison of Cerebral perfusion pressure values based on mean arterial pressure measured at the tragus and intracranial pressure obtained via transcranial Doppler using a cardiac probe at the M1 segment of the ipsilateral middle sylvian artery corresponding to the jugular vein under study.
Time frame
At inclusion (day 0)2
Cerebral perfusion pressure at 30° and at angle α (2)
Comparison of Cerebral perfusion pressure values based on diastolic, systolic, and mean blood flow velocities obtained via transcranial Doppler using a cardiac probe at the M1 segment of the ipsilateral middle sylvian artery corresponding to the jugular vein under study.
Time frame
At inclusion (day 0)3
Cerebral perfusion pressure at 30° and at angle α (3)
Comparison of Cerebral perfusion pressure values based on pulsatility index obtained via transcranial Doppler using a cardiac probe at the M1 segment of the ipsilateral middle sylvian artery corresponding to the jugular vein under study.
Time frame
At inclusion (day 0)4
Intracranial pressure
Ultrasound measurement using a vascular probe at angles of 0°, 10°, 20°, 30°, and the calculated angle α.
Time frame
At inclusion (day 0)Sponsors and contacts
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Source ClinicalTrials.gov
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