Blood flow and oxygenation following subarachnoid haemorrhage
Research type
Research Study
Full title
The effect of cerebrospinal fluid drainage and augmentation of cerebral perfusion on cerebral oxygenation and hemodynamics after subarachnoid haemorrhage
IRAS ID
121842
Contact name
Jonathan Coles
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust & University of Cambridge
Research summary
This study aims to look at how we can improve the blood flow and oxygen delivery to the brain following spontaneous bleeding (subarachnoid haemorrhage) from an abnormal swollen blood vessel (cerebral aneurysm). We know that bleeding in the brain can result in a reduction in the supply of blood and oxygen to the brain and result in stroke and poor functional outcome. Current treatment focuses on preventing stroke by increasing brain blood flow and oxygen supply through controlling pressure within the brain and increasing blood pressure.
There are several treatments capable of increasing blood flow and oxygen supply to the injured brain. We can remove fluid that accumulates in the head (cerebrospinal fluid) and thereby decrease pressure within the head and improve blood flow. Or we can increase blood pressure and increase the flow of blood into the brain. Although both treatments are currently widely used we do not understand which is most effective.
The current gold standard technique for measuring blood and oxygen supply to the brain is PET imaging but this cannot be used continuously at the bedside. Another technique called near-infrared spectroscopy (NIRS) that measures light absorption through the skin can be applied easily at the bedside and provide a measure of brain oxygen delivery without ill effects for as long as required. We will perform PET/MR imaging and NIRS monitoring in two groups (15 subjects in each) who will be randomly selected to receive one treatment intervention. In one group we will drain, in a controlled manner, excess fluid from the brain in order to reduce pressure within the brain. In the second group we will increase blood pressure to improve brain blood flow. We will perform PET imaging and NIRS before and after intervention to assess the improvement in oxygen supply to the brain.REC name
East of England - Cambridge Central Research Ethics Committee
REC reference
13/EE/0096
Date of REC Opinion
21 May 2013
REC opinion
Further Information Favourable Opinion