Neurogenic Myocardial and Lung Injury in SAH Patients

Medical University of Silesia

Status: Enrolling

Conditions: Subarachnoid Hemorrhage; Lung Injury; Myocardial Injury

Treatments: Diagnostic Test: hs-TnT (high-sensitive cardiac troponin T) plasma concentration; Diagnostic Test: CK-MB (creatine kinase myocardial band) plasma concentration; Diagnostic Test: NT-proBNP (N-terminal prohormone of brain natriuretic peptide) plasma concentration; Diagnostic Test: CPK (creatine phosphokinase) plasma concentration; Diagnostic Test: Metanephrine concentration in urine

Study type: Observational

Funder types: Other

Identifiers

NCT05408988

PCN/0022/KB/206/20

Details and patient eligibility

About

Up to this day, little is known whether the extent of brain damage in patients with SAH correlates with the degree neurogenic myocardial injury and neurogenic lung injury.

This is a prospective observational study designed to asses relationship between catecholamine surge and development of myocardial and lung injury in subarachnoid haemorrhage patients.

Full description

Multiple forms of brain damage, primarily, subarachnoid haemorrhage (SAH) are frequently accompanied by neurogenic myocardial injury with changes in the electrocardiogram, accompanied by the release of markers of myocardial injury. This form of cardiac dysfunction is thought to be mediated by cellular toxicity associated with catecholamine release. Central nervous system damage in the course of intracranial haemorrhage may, in a similar pathogenic pathway, lead to neurogenic lung injury. Up to this day, little is known whether the extent of brain damage in patients with SAH correlates with the degree of neurogenic myocardial injury. Moreover, it remains unknown what is the full clinical picture and duration of this type of myocardial injury and how often it co-occurs with neurogenic lung injury. Such analysis is a fundamental and most important step in optimising the treatment of these patients.

Methods: In this prospective observational study the authors aim to recruit 30 patients with subarachnoid haemorrhage, requiring hospitalization in the Intensive Care Unit. The patients will be monitored for elevation in cardiac damage markers (hs-TnT, CPK, CK-MB, NT-proBNP) and worsening of respiratory conditions, defined by need for more invasive ventilation parameters, and subsequent changes in arterial blood gas. The above mentioned parameters will be assessed every 12 hours. Additionally, the patients will be screened for an elevation in catecholamine metabolite (metanephrine) concentration in 12-hour urine collection.

Hypothesis to be tested: Myocardial and lung injury in SAH patients is timely-associated with an increase in metanephrine concentration in urine.

Enrollment: 30 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients with subarachnoid haemorrhage (both aneurysmal and non-aneurysmal) with acute consciousness disturbances (Glasgow Coma Scale < 8 pts) requiring intubation and mechanical ventilation, hospitalized in the ICU for over 24 hours

Exclusion criteria

• severe prior pulmonary diseases
• severe prior cardiac diseases
• death in the first 72 hours of ICU stay
• need for any extracorporeal life-saving techniques

Trial design

30 participants in 1 patient group

Patients with subarachnoid haemorrhage

Description:

Patients aged 18 or older hospitalized in the Intensive Care Unit with Subarachnoid Haemorrhage.

Treatment:

Diagnostic Test: CPK (creatine phosphokinase) plasma concentration

Diagnostic Test: Metanephrine concentration in urine

Diagnostic Test: hs-TnT (high-sensitive cardiac troponin T) plasma concentration

Diagnostic Test: CK-MB (creatine kinase myocardial band) plasma concentration

Diagnostic Test: NT-proBNP (N-terminal prohormone of brain natriuretic peptide) plasma concentration