International Trial of Efficacy of Cytoflavin in Head Trauma (MITRA)
Head Trauma,Closed
About this trial
This is an interventional treatment trial for Head Trauma,Closed focused on measuring closed head injury, brain concussion, traumatic brain injury, TBI, Craniocerebral Trauma, posttraumatic amnesia
Eligibility Criteria
Inclusion Criteria:
- Age from 18-60 (inclusive).
- Clinical diagnosis of TBI, cerebral contusion of moderate severity without compression.
- The written consent of the legal representative or the decision of the council to include the patient in the study.
- Possibility of a full assessment of eye opening, speech and motor response by GCS.
- GCS at the time of inclusion 9 - 14 (inclusive).
- Time of initiation of study drug therapy within 24 hours after the estimated or determined time of injury.
- The presence of post-traumatic amnesia, confusion and disorientation.
- Absence of indications for neurosurgery or other surgical intervention under general anesthesia.
- Normal brain CT scan, or the presence of subarachnoid hemorrhage and / or contusion foci of I-III types according to Kornienko and / or limited or diffuse cerebral edema.
- The expected duration of hospital stay >= 10 days.
- Absence of a disabling neurological or mental illness, information about the patient's disability prior to injury.
- Possibility to perform all procedures stipulated by the study protocol
Exclusion Criteria:
- The need to use the therapy prohibited by the study protocol.
- Concomitant injury, except for cases of damage to the skeleton, soft tissues, internal organs, which do not require (1) surgical intervention under general anesthesia, and (2) are not an independent indication for hospital treatment.
- Past / planned surgical intervention for the current episode of trauma under general anesthesia.
- Penetrating open TBI.
Presence of the following lesions on the results of computed tomography (CT) of the brain performed prior to the patient's randomization:
- epidural hematoma or subdural hematoma;
- evidence of a previous head injury based on CT results;
- type IV contusion foci according to Kornienko's classification.
- Presence of any of the following risk factors for secondary brain injury at any time after TBI: hypoxia (SpO2 <90% based on pulse oximetry results); hypotension (systolic blood pressure <90 mm Hg) or shock;hypothermia (body temperature <35 ° C); clinical signs of respiratory failure, the need for mechanical ventilation.
- Drug addiction.
- Alcohol in saliva >=2 ‰ or a previous diagnosis of alcohol dependence.
- Depression of consciousness, presumably resulting from other reasons (for example, alcohol, drugs, drugs, poisonous substances).
- The presence of aphasia due to focal brain damage, which prevents communication with the researcher.
- Status epilepticus at the time of admission to the hospital or condition after an epileptic seizure.
- Pregnant and lactating women.
- Availability of information about concomitant chronic disease in the stage of decompensation.
- Intolerance to the components of CYTOFLAVIN®, anamnestic data on drug allergy to succinic acid, riboflavin, inosine, or nicotinamide.
- Severe renal or heart failure requiring restriction of the volume of injected fluid.
- The presence of a condition or disease that, in the opinion of the investigator, jeopardizes the patient's safety if the patient participates in the study, or may interfere with the performance of examination procedures, an objective assessment of the patient's condition, or distort the assessment of the outcome of TBI.
- Participation in any clinical study less than 3 months before the start of the study.
- Patients who are employees of the research center and their families.
- Language barrier.
- Availability of information that the patient is a stateless person or a citizen of another state
Sites / Locations
- Ivanovskaya Regional Clinical HospitalRecruiting
- City Clinical Hospital No. 67 named after L.A. VorokhobovRecruiting
- Research Institute of Emergency Medicine n.a. N.V. SklifosovskyRecruiting
- Nizhny Novgorod Regional Clinical Hospital named after N.A. SemashkoRecruiting
- City Hospital of the Holy Martyr ElizabethRecruiting
- Stavropol Regional Clinical HospitalRecruiting
- State Autonomous Healthcare Institution of the Sverdlovsk Region "Central City Clinical Hospital No. 23"Recruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Cytoflavin ((Inosine + Nicotinamide + Riboflavin + Succinic Acid)
Placebo
Patients will receive treatment with the study drug, 20 ml twice a day IV, dissolved in 200 ml of 0.9% NS, for 10 days;patients will stay in the hospital for the the entire period of therapy. Observation of patients and assessment of the main parameters of the efficacy and safety will continue for 14 days.
Patients will receive 20 ml placebo (0.9% sodium chloride solution) twice a day IV, dissolved in 200 ml of 0.9% NS, for 10 days; patients will stay in the hospital for the the entire period of therapy. Observation of patients and assessment of the main parameters of the efficacy and safety will continue for 14 days.