Evaluating the Impact of Adjuvant Use of Beta Blockers on Clinical Outcomes in Patients With Traumatic Brain Injury
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: control, propranolol, Carvedilol.
- Who it may be relevant to
- Registry conditions: TBI Traumatic Brain Injury. Basic parameters: 18 years — 75 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Egypt
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Propranolol primarily acts as a non-selective beta blocker, blocking both beta-1 and beta-2 adrenergic receptors, while carvedilol exhibits a broader spectrum of action by also blocking alpha-1 adrenergic receptors. The receptor blockade profile of a beta blocker can influence its physiological effects and potential therapeutic benefits in TBI. Therefore, the variation in receptor selectivity may result in differences in their impact on secondary brain injury processes and patient outcomes.
Interventions
- Drug control
Patients will receive standard care with no interventions until end of treatment. - Drug propranolol
starting at 20mg propranolol three times daily by mouth or per feeding tube. The dose was increased daily in 20mg three times daily increments (60mg/day total) until heart rate (HR) was less than 100 beats per minute (bpm) with maximum dose of 640mg/day in addition to standard care until end of treatment. - Drug Carvedilol
starting at 6.25mg carvedilol three times daily by mouth or per feeding tube. The dose was increased daily in 6.25 mg three times daily increments (18.75 mg/day total) until heart rate (HR) was less than 100 beats per minute (bpm) with maximum dose of 100 mg/day in addition to standard care until end of treatment.
Primary outcome measures
- Incidence of In-hospital mortality [Time frame: 14 days]
Eligibility criteria
Inclusion criteria
1\. Patients with moderate \& severe TBI detected on admission by CT scan and GCS score of ≤ 13 who either do not have any other injuries or only have associated minor injuries.
Minor injuries are defined as presence of any of the following:
- Mild intraperitoneal free fluid (IPFF) observed through abdominal ultrasound.
- mild lung contusion detected in the chest CT scan.
- hemothorax or pneumothorax present without accompanying symptoms of hypoxia, tachypnea, or respiratory distress.
- simple limb fractures.
Exclusion criteria
- Patients on pre-injury beta-blocker therapy.
- Patients with any bronchospastic conditions.
- Patients with active acute coronary syndrome.
- TBI with GCS ≤ 13 with associated major injuries defined as the presence of any of the following:
- Moderate \& marked IPFF requiring surgical intervention ( laparotomy ).
- moderate \& marked lung contusion, pneumothorax \& hemothorax with accompanying symptoms of hypoxia, tachypnea, lower limbs, or limb amputation.
- Compound fracture in the upper or lower limb.
- Open Faciomaxillary trauma.
- Patients with persistent shock (systemic blood pressure <100 mmHg, base deficit > 4, or oliguria , HR < 60 b/min ) after > one week of admission.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Egypt · 2 centers
- Zagazig University Hospitals, Zagazig, — Zagazig
- Zagazig University Hospitals — Zagazig
Identifiers
NCT: NCT06836856 · 2024-37