Non-invasive multimodal brain monitoring in clinical neuroscience
Research type
Research Study
Full title
Non-invasive multimodal monitoring of the brain in clinical neuroscience - brain function in comatose patients undergoing medical intensive care (Triple-M)
IRAS ID
165207
Contact name
Maxwell Damian
Contact email
Sponsor organisation
Cambridge University Hospitals NHS FT and University of Cambridge
Duration of Study in the UK
0 years, 11 months, 28 days
Research summary
Preservation of the brain's integrity is critical to achieve good outcomes in the treatment of critically ill patients in the intensive care unit. It would be ideal to monitor neurological function continuously, like cardiovascular monitoring. However, in patients undergoing sedation and paralysis, the clinical examination cannot adequately evaluate neurological status. For patients undergoing brain surgery it has become standard of care to monitor multiple aspects of brain function via inserted probes that measure intracranial pressure, oxygenation, and chemical parameters – the so called multimodal invasive monitoring. In patients who are not undergoing brain surgery, invasive monitoring that breaches the skull surgically is seldom feasible, and clinicians rely on intermittent, limited assessments. Even in medical conditions where the brain is regularly and significantly affected, an effective non-invasive monitoring regime has not yet been established.
This study will investigate the feasibility and clinical benefit of applying a multimodal non-invasive monitoring strategy to medical conditions in order to provide continuous assessment of brain function. The monitoring technique involves integrating Near Infrared Spectroscopy, Transcranial Doppler Ultrasound, Electroencephalography, Transcranial Magnetic Stimulation and Evoked Potential recording to assess cerebral autoregulation and neuronal activity.
We propose to recruit patients in the acute phase of conditions where neurological complications are frequent and crucial, including hypoxic and metabolic encephalopathies, sepsis, refractory status epilepticus, and cardiac surgery. Patients will be investigated in the intensive care units of Addenbrooke's Hospital, Cambridge and the results of monitoring will be correlated with their further clinical course. The results will be validated against clinical outcomes.REC name
London - South East Research Ethics Committee
REC reference
16/LO/1971
Date of REC Opinion
8 Dec 2016
REC opinion
Further Information Favourable Opinion