Cerebral Hemorrhage Clinical Trial
Official title:
Safety and Efficacy of NBO in Acute Intracerebral Hemorrhage
Intracerebral hemorrhage (ICH) is one of the most devastating nontraumatic cerebral vascular
diseases. Its exacerbation is often related to a mass effect because of hematoma formation
and edema in the perihematoma, which plays a key role in disease deterioration. Perihematoma
edema is an important contributor to brain injuries secondary to ICH and one of the risk
factors that leads to disease deterioration and high mortality. Brain edema following ICH was
believed to be induced by the breakdown of the blood-brain barrier and ischemia and hypoxia
of the perihematoma.
Normobaric oxygen (NBO) therapy is a treatment that delivers high-flow oxygen at normobaric
pressure through a facemask to supplement the oxygen supply,which maintain the oxygen
concentration of typically 40-100% ,can increase the arterial oxygen content, and alleviate
tissue hypoxia. NBO therapy has been shown to provide neuroprotection against ischemic stroke
in an experimental study and a clinical trial. To the best of our knowledge, the potential of
NBO therapy for neuroprotection against human hemorrhagic stroke has not been investigated.
There are two studies about NBO interventions in the rat model of intracerebral
hemorrhage.The one showed NBO did not worsen hemorrhage severity or brain edema. There were
no significant differences in hemorrhagic blood volumes or brain water content. NBO did not
affect any of the neurological outcome tests in the primary or secondary studies. Another one
showed NBO groups improved NSSs,decreased contents of brain water, HIF-1α and VEGF, and fewer
apoptotic cells in the perihematoma at 72 h after ICH compared with the ICH control group.
These results suggest that NBO therapy with oxygen delivered at 90% conferred best
neuroprotection to ICH rats, potentially through amelioration of brain edema by suppressing
HIF-1α and VEGF expression in the perihematoma.
But there is no clinical study on the safety and efficacy of NBO in patients with
intracerebral hemorrhage.NBO has the advantages of simple operation, non-invasiveness and
early application, which makes it have great application prospects in the treatment of ICH.
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