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Trial registered on ANZCTR
Registration number
ACTRN12623000594628
Ethics application status
Approved
Date submitted
17/05/2023
Date registered
31/05/2023
Date last updated
20/11/2023
Date data sharing statement initially provided
31/05/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Assessing the feasibility and benefits of Ketamine Sedation in Acute Brain Injury
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Scientific title
Ketamine Sedation in Acute Traumatic Brain Injury in Adults: A randomized pilot feasibility study.
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Secondary ID [1]
309610
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Nil
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Universal Trial Number (UTN)
U1111-1292-5987
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Trial acronym
KIBI
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Traumatic Brain Injury
330009
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Condition category
Condition code
Injuries and Accidents
326916
326916
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0
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Other injuries and accidents
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Neurological
327004
327004
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Ketamine delivered via continuous intravenous infusion at 1mg/kg/hr of lean body mass for a maximum of 120hrs (5 days) then ceased. Ketamine is in addition to standard sedation which must include an infusion of GABA agonist medication e.g. Propofol or Mizadolam. Protocol compliance will be monitored via the electronic medical record.
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Intervention code [1]
326100
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Treatment: Drugs
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Comparator / control treatment
Standard sedation (no ketamine infusion or placebo) which must include an infusion of GABA agonist medication e.g. Propofol or Mizadolam.
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Control group
Active
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Outcomes
Primary outcome [1]
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Feasibility of administering Ketamine for 48hrs via continuous infusion determined by dose of Ketamine administered via patient electronic medical record
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Assessment method [1]
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Timepoint [1]
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48hrs post commencement of ketamine infusion
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Secondary outcome [1]
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Cumulative dose of vasoactive medications recorded in patient electronic medical record.
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Assessment method [1]
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Timepoint [1]
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Day 7 post enrolment
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Secondary outcome [2]
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Cumulative dose of sedative medications recorded in patient electronic medical record.
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Assessment method [2]
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Timepoint [2]
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Day 7 post enrolment
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Secondary outcome [3]
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Incidence of delirium requiring pharmacological management recorded in the electronic medical record
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Assessment method [3]
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Timepoint [3]
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Day 14 post enrolment
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Eligibility
Key inclusion criteria
First admission to the intensive care unit (ICU) for management of moderate to severe traumatic brain injury with abnormal CT scan, Glasgow Coma Score <12 points and requirement from intracranial pressure monitoring
Clinically stable and sedated with an infusion of GABA agonist medication
Expected period of sedation >72hrs
For full active management
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Pregnancy
Documented or suspected hypersensitivity to Ketamine
Known of suspected chronic kidney or liver disease
History of coronary artery disease or evidence of acute coronary syndrome
Admitted for palliative management
Greater than 72hrs elapsed since admission to the ICU
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer sequence generation with permuted blocks. Stratification by age.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
5/06/2023
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Actual
8/08/2023
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Date of last participant enrolment
Anticipated
23/05/2025
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Actual
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Date of last data collection
Anticipated
6/06/2025
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Actual
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Sample size
Target
40
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Accrual to date
4
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
24739
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The Alfred - Melbourne
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Recruitment postcode(s) [1]
40360
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3004 - Melbourne
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Alfred Research Trusts
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Address [1]
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55 Commercial Rd, Melbourne VIC 3004
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Country [1]
313790
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Australia
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Primary sponsor type
Hospital
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Name
Alfred Health
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Address
55 Commercial Rd, Melbourne VIC 3004
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Country
Australia
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Secondary sponsor category [1]
315692
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None
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Name [1]
315692
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Address [1]
315692
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Country [1]
315692
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
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55 Commercial Rd, Melbourne VIC 3004
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
312958
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Approval date [1]
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23/11/2021
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Ethics approval number [1]
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HREC/75693/Alfred-2021
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Summary
Brief summary
Patients with acute traumatic brain injury (TBI) requiring admission to the ICU, commonly receive sedative drugs to reduce the brain’s demand for oxygen and glucose. These patients often also require pain-relieving (analgesic) medications. Ketamine is a combined sedative and analgesic medication that is not currently used in acute TBI but has the potential to benefit this patient group for several reasons: 1. It can reduce the need for high doses of other sedatives and analgesic drugs which may accumulate or cause low blood pressure 2. It can reduce or eliminate the need for other drug infusions which are required to maintain a normal or high blood pressure during the treatment of TBI 3. It has been shown to reduce the incidence of damaging waves of brain activation that travel across the surface of the brain after severe TBI (Spreading Depolarizations). This pilot feasibility study aims to demonstrate that using Ketamine sedation is safe in acute TBI patients admitted to the ICU and will establish the methodology for a larger randomised controlled trial.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Andrew Udy
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Address
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Department of Intensive Care and Hyperbaric Medicine
Alfred Hospital
Level 2, 541 St Kilda Rd
Melbourne VIC 3004
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Country
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Australia
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Phone
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+61 438 755 568
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Meredith Young
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Address
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Department of Intensive Care and Hyperbaric Medicine
Alfred Hospital
Level 2, 541 St Kilda Rd
Melbourne VIC 3004
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Country
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Australia
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Phone
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+61390768034
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Toby Jeffcote
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Address
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Department of Intensive Care and Hyperbaric Medicine.
Alfred Hospital
Level 2, 541 St Kilda Rd
Melbourne VIC 3004
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Country
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Australia
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Phone
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+61 423 962 386
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Data sharing requests will be reviewed by the management committee
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When will data be available (start and end dates)?
3 months after publication with no end date determined.
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Available to whom?
Case-by-case basis at the discretion of the Management Committee
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Available for what types of analyses?
To achieve the aims in the approved proposal
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How or where can data be obtained?
Contact the management committee via Dr Toby Jeffcote -
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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