A New Minimal-invasive Brain Tissue Probe Applying Near Infrared Spectroscopy

Study Overview
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Brief Summary
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To assess the feasibility of a new brain tissue probe for multi-parameter neuromonitoring (NeMo Probe) and the accuracy of measurement values. To demonstrate the ability of the NeMo probe to detect changes in cerebral hemodynamics and oxygenation during cerebrovascular events monitored with established methods including brain tissue oxygenation tension and microdialysis

Official Title
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A New Multi-parameter Monitoring System Applying Near Infrared Spectroscopy and Indocyanine Green to Detect Cerebrovascular Events in Patients With Subarachnoid Hemorrhage

Conditions
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Spontaneous Subarachnoid Hemorrhage

Intervention / Treatment
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* Device: NeMo Probe


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Males and females aged 18-75 years (inclusive) Patients with high-grade subarachnoid hemorrhage (WFNS 4-5) Decreased level of consciousness with the need for intracranial pressure monitoring Successful exclusion of the ruptured aneurysm with clipping or coiling Women of childbearing potential must have a negative serum pregnancy test Written informed consent obtained by a legal representative Exclusion Criteria: Significant kidney and/or liver disease Any severe unstable concomitant condition or disease (e.g. cancer, coronary disease) or chronic condition (e.g. psychiatric disorder, chronic obstructive pulmonary disease Grade II, chronic heart failure > NYHA II) Cerebrospinal fluid infection or signs of meningoencephalitis Acute respiratory distress syndrome (ARDS), pulmonary edema Preexisting coagulation disorder Patients with current alcohol or drug abusus or dependence Patients with a history of hypersensitivity against indocyanine green or sodium iodine Patients with thyroid disease causing hyperthyroidism Breast-feeding women Patients committed to an institution based on official directive or court order

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: NeMoProbe<br>The NeMo System is used for intracranial pressure (ICP) and brain temperature monitoring, as well as the determination of the brain tissue oxygenation saturation (SbtO2) and cerebral blood flow. The sensors for NIRS are implemented into a conventional brain tissue probe for ICP monitoring (NeMo Probe). | Device: NeMo Probe<br>* A new minimal-invasive brain tissue probe applying near infrared spectroscopy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To assess the feasibility of the neuromonitoring system and accuracy of the measurement values | Feasibility: User acceptance rate in comparison to conventional probes for ICP-monitoring. The following parameters will be analysed: Incidence of concerns of users in relation to the installation of the NeMo System Incidence of concerns of users in relation to the function of the NeMo System Incidence of concerns of users in relation to the removal of the NeMo System User-friendliness with a 3-graded scale (equal, better, worse) compared to conventional probes for ICP monitoring Accuracy of measurement values: Results from repeated measurements of mttICG, CBV, and CBF. Safety endpoints: -Adverse events profile (including adverse device effects): Incidence of complications (infections, brain tissue damage, hemorrhage) in comparison to historical series (conventional probes for ICP-monitoring): | Day 90 after Removal of Medical Device | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To demonstrate the ability of the neuromonitoring system to detect cerebrovascular events in patients with subarachnoid hemorrhage | Results concerning the response to cortical spreading depolarization (CSD) monitored with electrocorticography (ECoG): Increase of brain tissue oxygenation (SbtO2), total hemoglobin (dHbtotal, aHbtotal), CBV, CBV Hb and CBF >20% Decrease of SbtO2, dHbtotal, aHbtotal, CBV, CBV Hb and CBF >20% Changes of SbtO2, dHbtotal, aHbtotal, CBV, CBV Hb and CBF <20% Results concerning the sensitivity and specificity to detect delayed cerebral ischemia (DCI) monitored with ptiO2 and MD: Correlation of CBF values <15 ml/100g/min with defined criteria for DCI (ptiO2 <15 mmHg, Gluc brain<0.7 mmol/l, Lactate-Pyruvate-Ratio >40), number of false negative and false positive events, Receiver Operating Characteristic (ROC) curve. | Day 90 after Removal of Medical Device |