ONSD Trajectory in Rebound ICH
- Sponsor
- Benha University
- Study ID
- NCT07722702
- Status
- Not Yet Recruiting
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Conditions
- Cerebral Edema
- Rebound Intracranial Hypertension
- Traumatic Brain Injury
Eligibility Criteria
- Sex
- ALL
- Age
- 18 Years - 80 Years
- Healthy Volunteers
- Not accepted
Interventions
- Optic Nerve Sheath Diameter Ultrasonography — DIAGNOSTIC_TESTSerial ultrasonographic measurement of optic nerve sheath diameter (ONSD) will be performed bilaterally using a standardized transorbital ultrasound technique immediately before osmotherapy reduction or discontinuation (baseline) and at 4, 6, 12, and 24 hours after weaning. Additional measurements may be obtained if clinical deterioration suggestive of rebound intracranial hypertension occurs. ONSD measurements are performed for observational purposes only and will not influence routine clinical management.
Study Details
The goal of this prospective observational study is to determine whether the trajectory of optic nerve sheath diameter (ONSD) after osmotherapy weaning can predict rebound intracranial hypertension in adult patients with traumatic brain injury requiring osmotherapy for elevated intracranial pressure. The main questions it aims to answer are: Does the trajectory of ONSD during osmotherapy weaning predict the development of rebound intracranial hypertension? What is the diagnostic accuracy of serial ONSD measurements for the early detection of rebound intracranial hypertension? Researchers will compare patients who develop rebound intracranial hypertension with those who do not to determine whether changes in ONSD trajectory differ significantly between the two groups. Participants will: Undergo serial bedside ocular ultrasound examinations for ONSD measurement at predefined time points after osmotherapy weaning. Receive standard clinical management for traumatic brain injury according to institutional protocols; no additional therapeutic intervention will be administered. Undergo routine neurological assessments, laboratory investigations, and neuroimaging as clinically indicated. Be followed for the occurrence of rebound intracranial hypertension and relevant clinical outcomes during their ICU stay
Key Dates
- First listed
- Jul 23, 2026
- Start date
- Sep 1, 2026
- Status verified
- Jul 2026
- Primary completion
- Sep 1, 2027
- Completion
- Oct 1, 2027
Study Design
- Enrollment
- 100 participants (estimated)
Arms
- Arm: Traumatic Brain Injury Patients Undergoing Osmotherapy WeaningAdult patients with traumatic brain injury receiving osmotherapy for intracranial hypertension who undergo protocol-defined osmotherapy weaning. Participants will undergo serial optic nerve sheath diameter (ONSD) measurements before and after osmotherapy reduction or discontinuation and will be followed prospectively for the development of rebound intracranial hypertension and related clinical outcomes.
Primary Outcome Measure
Prediction of rebound intracranial hypertension using serial ONSD measurements [ Time Frame: Within 24 hours after osmotherapy reduction or discontinuation ]
Central Contacts
- Mostafa Mohamed Sakr, Critical care MSC+201002338765
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