Critical Illness Clinical Trial
— BRAIN-2Official title:
BRAIN-ICU-2 Study: Bringing to Light the Risk Factors And Incidence of Neuropsychological Dysfunction (Dementia) in ICU Survivors, 2nd Study
This BRAIN-ICU-2 study [Bringing to light the Risk factors And Incidence of Neuropsychological dysfunction (dementia) in ICU Survivors, 2nd Study] is in direct response to PAR-17-038 and will determine ICU patients' main paths to decline, maintenance, or recovery of brain function. We will answer gaps in knowledge about long-term outcome of post-ICU brain disease by following the remaining ICU survivors from the original BRAIN-ICU-1 study with complete cognitive testing for the first time ever to 12 years (AIM 1). We will consent and enroll 567 new ICU patients at Vanderbilt and Rush Universities (i.e., BRAIN-ICU-2 cohort) and determine how detailed neuroimaging and cerebrospinal fluid samples can help reveal locations and mechanisms of injury beyond what we learned from the clinical information collected in our original study (AIM 2). Importantly, we are mirroring the existing world-renowned Rush Alzheimer's Disease Research Center brain bank program so that all patients enrolled in Aims 1 and 2 will able to donate their brains to science for the first-ever in-depth pathological study of those who do and do not get post-ICU dementia to define this disease formally (AIM 3)
Status | Recruiting |
Enrollment | 567 |
Est. completion date | January 31, 2027 |
Est. primary completion date | January 31, 2026 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: *Adult patients in a medical and/or surgical ICU for the treatment of: - shock (e.g., with vasopressors, - intra-aortic balloon pump, - Extracorporeal Membrane Oxygenation therapy) and/or - respiratory failure [e.g., on mechanical ventilation or non-invasive positive pressure ventilation (NIPPV)] Exclusion Criteria: 1. MRI incompatibility (e.g. known claustrophobia, permanent metal implants) 2. Cumulative ICU time > 5 days in the past 30 days, prior to this hospitalization 3. Inability to start the informed consent process within the 72 hours following organ failure: - Attending physician refusal - Patient and/or surrogate refusal - 72-hour period of eligibility was exceeded before the patient was screened - Patient unable to consent and no surrogate available within the 72-hour period 4. Residence > 100 miles from study site and do not regularly visit the area. 5. Patients who are homeless and have no secondary contact person available. 6. Cardiac surgery within the current hospitalization 7. Dementia or other chronic neurologic disease or disorder that either makes the patient incapable of living independently at baseline or results in an IQCODE >3.8(completed by the patient or their qualified surrogate). (Examples include but are not limited to mental illness requiring long-term institutionalization, acquired or congenital mental retardation, Parkinson's disease, Huntington's disease, severe Alzheimer's disease or dementia of any etiology, and debilitating cerebrovascular disease.) 8. Acute or subacute neurologic deficit that is expected to make the patient incapable of living independently after hospital discharge due to cognitive deficits. (Examples include, but are not limited to stroke, intracranial hemorrhage, cranial trauma, intracranial malignancy, anoxic brain injury, and cerebral edema.) 9. Inability to understand English or Spanish or bilateral deafness or bilateral vision loss 10. Current enrollment in a study that does not allow co-enrollment 11. Prisoners 12. Active substance abuse or psychotic disorder (e.g., schizophrenia or schizo-affective disorder) or recent (within the past 2 years) serious suicidal gesture necessitating hospitalization. 13. Expected death within 12 hours of enrollment or lack of commitment to treatment by family or the medical team (e.g., likely to withdraw life support measures within 12 hours of enrollment) |
Country | Name | City | State |
---|---|---|---|
United States | Rush University Medical Center | Chicago | Illinois |
United States | Vanderbilt University Medical Center | Nashville | Tennessee |
Lead Sponsor | Collaborator |
---|---|
Vanderbilt University Medical Center | National Institute on Aging (NIA) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of participants whose brains show dementia-type changes in brain structure. | Up to 312 weeks |
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