Acetaminophen in aSAH to Inhibit Lipid Peroxidation and Cerebral Vasospasm
Aneurysmal Subarachnoid Hemorrhage, Cerebral Vasospasm
About this trial
This is an interventional treatment trial for Aneurysmal Subarachnoid Hemorrhage focused on measuring Lipid, Peroxidation, N-Acetylcysteine, Acetaminophen, Vasospasm
Eligibility Criteria
Inclusion Criteria:
- Ages ≥ 20
- Fisher Grade III or III + IV SAH based upon admitting CT scan
- Aneurysm secured by either clipping or coiling within 72 hours of SAH
- Intracranial aneurysm confirmed by angiography or CTA
- Presence of ventriculostomy for external ventricular drainage (EVD) prior to randomization
Exclusion Criteria:
- Consent unobtainable
- Enrollment in another interventional study
- Patient is pregnant or lactating
- Known co-morbidities that could affect outcome of this study
- Contraindication to CTA
- Serum creatinine > 1.4
- Documented allergy to iodinated contrast that cannot be adequately treated with premedication
- Documented allergy and/or intolerance to ApAP
- Baseline liver disease
- History of recent alcohol abuse with documented ALT or AST above normal laboratory values
- Documented history of both malnutrition and decreased serum albumin below normal lab values
- Documented abnormal platelet count below normal lab values
- Documented abnormal PT or PTT above normal lab values
- History or evidence of active asthma
- Documented allergy and/or intolerance to N-acetylcysteine
- Currently taking phenytoin, carbamazepine, or phenobarbital
- Currently taking isoniazid (INH, Lanzid, Nydrazid)
- Severe life-threatening complications resulting from standard aneurysm treatments that will likely prevent completion of the study
- Patient unsuitable for the study, in the opinion of the investigator(s)
Sites / Locations
- Vanderbilt University Medical Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Placebo Comparator
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Placebos for acetaminophen and N-acetylcysteine
Acetaminophen and N-acetylcysteine placebo
N-acetylcysteine and acetaminophen
Acetaminophen 1 Gram and N-acetylcysteine
Acetaminophen 1.5 Gram and N-acetylcysteine
Placebos for acetaminophen and N-acetylcysteine
Acetaminophen 1 gm every 6 hours and N-acetylcysteine placebo
N-acetylcysteine IV infusion at 0.5 gm hourly and acetaminophen placebo
Acetaminophen 1 gm every 6 hours, plus N-acetylcysteine IV infusion at 0.5 gm hourly
Acetaminophen 1.5 gm every 6 hours, plus N-acetylcysteine IV infusion at 0.5 gm hourly