HES Patch Versus Blood Patch
Primary Purpose
Intracranial Hypotension
Status
Completed
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
injection of HES " Voluven® "
blood patch
Sponsored by
About this trial
This is an interventional treatment trial for Intracranial Hypotension
Eligibility Criteria
Inclusion Criteria:
- Subjects older than 18 years.·
- Subjects with an intracranial hypertension syndrome secondary to an epidural, spinal or lumbar puncture (and therefore presumed iatrogenic) with a sub arachnoid space or subjects with intracranial hypertension syndrome of primitive origin requiring treatment with epidural Patch ·
- subjects with a temporal window of sufficient quality to carry out the transcranial Doppler ·
- Subjects haven read the informed consent, signed and dated prior to the start of any proceedings related to the tial·
- Subjects affiliated to health insurance·
- Subjects having been informed of the results of a prior medical consultation
Exclusion Criteria:
- Subjects with a cons-indication to an epidural Patch:
- blood disorders constitutional or acquired coagulation with platelets
- Subjects under treatment with curative doses of antiplatelet drugs or anticoagulants
- subjects under shock and / or hypovolemia
- subjects under generalized sepsis or at the puncture site
- any other cons-indication to performing an epidural
Sites / Locations
- Service Anesthésie Réanimation Chirurgicale Hôpitaux Universitaires de Strasbourg, 1 avenue Molière
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Blood Patch arm
Drug: injection of HES " Voluven® " patch arm
Arm Description
Standard of care arm: injection of autologous blood approximately 40 mL of blood sample into the epidural space at a rate of 1 ml / about 5 seconds.
Drug: injection of HES " Voluven® " into the epidural space of 15 to 30 ml at a rate of 1 ml / about 5 seconds
Outcomes
Primary Outcome Measures
Variation of the pulsatility index (PI) of the middle cerebral artery transcranial Doppler
Compare the effect of epidural injection of autologous blood (Blood Patch) versus injection of a colloid (HES Voluven ®) on cerebral blood flow.
this study aims at observing the variation of the pulsatility index (PI) of middle cerebral artery observed by a transcranial Doppler between T0 and 30 minutes after the patch is administered.
The BP or HEA treatment will be considered equivalent if the proportion of clinical failures and side effects do not differ by more than 5%.
Secondary Outcome Measures
Full Information
NCT ID
NCT02570724
First Posted
September 29, 2015
Last Updated
August 19, 2019
Sponsor
University Hospital, Strasbourg, France
1. Study Identification
Unique Protocol Identification Number
NCT02570724
Brief Title
HES Patch Versus Blood Patch
Official Title
Clinical Effect and Cerebral Vasoconstriction Induced After Epidural Blood Patch Versus Epidural Hydroxyethyl Starch Patch in Patients With Headache Due to Intracranial Hypotension
Study Type
Interventional
2. Study Status
Record Verification Date
August 2019
Overall Recruitment Status
Completed
Study Start Date
June 2013 (Actual)
Primary Completion Date
August 2018 (Actual)
Study Completion Date
August 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Strasbourg, France
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The injection of autologous blood Blood Patch (BP) into the epidural space is the standard treatment for headache associated with intracranial hypotension. It provokes cerebral vasoconstriction. It is cons-indicated in a number of situations (HIV positive, fever, sepsis, leukemia). The purpose of this study is to evaluate another technique using a patch made by injecting an epidural hydroxyethylstarch solution (HES 130, 0.4, 6%) instead of blood patch. This alternative technique is simple to implement and does not have some of the specific blood pressure contra-indications. The study aims at comparing the "Blood Patch" group versus the "HES Patch" in terms of clinical efficacy , tolerance, satisfaction of the anesthetist, ease of implementation and effect of the injection of epidural anesthesia on cerebral blood flow within 24 hours.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intracranial Hypotension
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Blood Patch arm
Arm Type
Active Comparator
Arm Description
Standard of care arm: injection of autologous blood approximately 40 mL of blood sample into the epidural space at a rate of 1 ml / about 5 seconds.
Arm Title
Drug: injection of HES " Voluven® " patch arm
Arm Type
Active Comparator
Arm Description
Drug: injection of HES " Voluven® " into the epidural space of 15 to 30 ml at a rate of 1 ml / about 5 seconds
Intervention Type
Drug
Intervention Name(s)
injection of HES " Voluven® "
Other Intervention Name(s)
HYDROXYETHYL STARCH
Intervention Description
Injection into the epidural space of 15 to 30 ml Voluven ® at a rate of 1 ml / about 5 seconds.
Intervention Type
Biological
Intervention Name(s)
blood patch
Other Intervention Name(s)
injection of autologous blood
Primary Outcome Measure Information:
Title
Variation of the pulsatility index (PI) of the middle cerebral artery transcranial Doppler
Description
Compare the effect of epidural injection of autologous blood (Blood Patch) versus injection of a colloid (HES Voluven ®) on cerebral blood flow.
this study aims at observing the variation of the pulsatility index (PI) of middle cerebral artery observed by a transcranial Doppler between T0 and 30 minutes after the patch is administered.
The BP or HEA treatment will be considered equivalent if the proportion of clinical failures and side effects do not differ by more than 5%.
Time Frame
36 hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects older than 18 years.·
Subjects with an intracranial hypertension syndrome secondary to an epidural, spinal or lumbar puncture (and therefore presumed iatrogenic) with a sub arachnoid space or subjects with intracranial hypertension syndrome of primitive origin requiring treatment with epidural Patch ·
subjects with a temporal window of sufficient quality to carry out the transcranial Doppler ·
Subjects haven read the informed consent, signed and dated prior to the start of any proceedings related to the tial·
Subjects affiliated to health insurance·
Subjects having been informed of the results of a prior medical consultation
Exclusion Criteria:
Subjects with a cons-indication to an epidural Patch:
blood disorders constitutional or acquired coagulation with platelets
Subjects under treatment with curative doses of antiplatelet drugs or anticoagulants
subjects under shock and / or hypovolemia
subjects under generalized sepsis or at the puncture site
any other cons-indication to performing an epidural
Facility Information:
Facility Name
Service Anesthésie Réanimation Chirurgicale Hôpitaux Universitaires de Strasbourg, 1 avenue Molière
City
Strasbourg
State/Province
Strasbourg Cedex
ZIP/Postal Code
67098
Country
France
12. IPD Sharing Statement
Learn more about this trial
HES Patch Versus Blood Patch
We'll reach out to this number within 24 hrs