Clinical trial NCT02045407: Computed Tomography Angiography Accuracy in Brain Death Diagnosis
Official title: Computed Tomography Angiography Accuracy in Brain Death Diagnosis
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Brain Death
Keywords: Brain Death
Neurological Death
Cerebral circulatory arrest
Computed Tomography Angiography
Lead sponsor: University of Sao Paulo
Sponsor class: OTHER
Collaborators: name: University of Sao Paulo
First posted: 2014-01-24
Enrollment: 106
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Individuals of any genre or age.

Brief summary: The purpose of this study is to assess the reliability of computed tomography angiography (CTA) to diagnose brain death, face of several conditions that make impossible to define such diagnosis using clinical criteria exclusively.

Detailed description: Critically ill patients, presenting Glasgow Coma Score 5 or lower, will be submitted to the Computed Tomography Angiography (CTA) of the skull assessment, and follow a clinical evaluation for brain death, additionally, transcranial Doppler would be applied as the gold standard for brain death.

We will exclude patients whose do not can be submitted to contrast injection, or if a brain death clinical evaluation has been performed prior the CTA.

Eligibility criteria: Inclusion Criteria:

* Individuals of any age or sex with brain death suspicion raised, before clinical test.
* Comatose patients presenting Glasgow Coma Score as or under 5 points, under sedative agents or not.

Exclusion Criteria:

* Brain dead patients clinically confirmed.
* Contraindications to the use of contrast medium (renal failure or allergy).

Primary outcomes:
measure: Assess the presence or absence of contrast medium filling of the intracranial vessels in comatose patients.
timeFrame: 1 year
Secondary outcomes:
Other outcomes:
Locations:
city: São Paulo
country: Brazil
facility: Hospital das Clínicas da Faculdade de Medicina da USP.
Study officials:
affiliation: University of Sao Paulo
name: Sergio Brasil, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Welschehold S, Kerz T, Boor S, Reuland K, Thomke F, Reuland A, Beyer C, Tschan C, Wagner W, Muller-Forell W, Giese A. Computed tomographic angiography as a useful adjunct in the diagnosis of brain death. J Trauma Acute Care Surg. 2013 May;74(5):1279-85. doi: 10.1097/TA.0b013e31828c46ba.
citation: Welschehold S, Kerz T, Boor S, Reuland K, Thomke F, Reuland A, Beyer C, Wagner W, Muller-Forell W, Giese A. Detection of intracranial circulatory arrest in brain death using cranial CT-angiography. Eur J Neurol. 2013 Jan;20(1):173-9. doi: 10.1111/j.1468-1331.2012.03826.x. Epub 2012 Jul 12.
citation: Rieke A, Regli B, Mattle HP, Brekenfeld C, Gralla J, Schroth G, Ozdoba C. Computed tomography angiography (CTA) to prove circulatory arrest for the diagnosis of brain death in the context of organ transplantation. Swiss Med Wkly. 2011 Oct 4;141:w13261. doi: 10.4414/smw.2011.13261. eCollection 2011.
citation: Bohatyrewicz R, Sawicki M, Walecka A, Walecki J, Rowinski O, Bohatyrewicz A, Kanski A, Czajkowski Z, Krzysztalowski A, Solek-Pastuszka J, Zukowski M, Marzec-Lewenstein E, Wojtaszek M. Computed tomographic angiography and perfusion in the diagnosis of brain death. Transplant Proc. 2010 Dec;42(10):3941-6. doi: 10.1016/j.transproceed.2010.09.143.
citation: Berenguer CM, Davis FE, Howington JU. Brain death confirmation: comparison of computed tomographic angiography with nuclear medicine perfusion scan. J Trauma. 2010 Mar;68(3):553-9. doi: 10.1097/TA.0b013e3181cef18a.
citation: Escudero D, Otero J, Marques L, Parra D, Gonzalo JA, Albaiceta GM, Cofino L, Blanco A, Vega P, Murias E, Meilan A, Roger RL, Taboada F. Diagnosing brain death by CT perfusion and multislice CT angiography. Neurocrit Care. 2009;11(2):261-71. doi: 10.1007/s12028-009-9243-7. Epub 2009 Jun 30.
citation: Frampas E, Videcoq M, de Kerviler E, Ricolfi F, Kuoch V, Mourey F, Tenaillon A, Dupas B. CT angiography for brain death diagnosis. AJNR Am J Neuroradiol. 2009 Sep;30(8):1566-70. doi: 10.3174/ajnr.A1614. Epub 2009 Apr 30.
citation: Dupas B, Gayet-Delacroix M, Villers D, Antonioli D, Veccherini MF, Soulillou JP. Diagnosis of brain death using two-phase spiral CT. AJNR Am J Neuroradiol. 1998 Apr;19(4):641-7.
citation: Leclerc X, Taschner CA, Vidal A, Strecker G, Savage J, Gauvrit JY, Pruvo JP. The role of spiral CT for the assessment of the intracranial circulation in suspected brain-death. J Neuroradiol. 2006 Apr;33(2):90-5. doi: 10.1016/s0150-9861(06)77237-6.
citation: Combes JC, Chomel A, Ricolfi F, d'Athis P, Freysz M. Reliability of computed tomographic angiography in the diagnosis of brain death. Transplant Proc. 2007 Jan-Feb;39(1):16-20. doi: 10.1016/j.transproceed.2006.10.204.
citation: Quesnel C, Fulgencio JP, Adrie C, Marro B, Payen L, Lembert N, El Metaoua S, Bonnet F. Limitations of computed tomographic angiography in the diagnosis of brain death. Intensive Care Med. 2007 Dec;33(12):2129-35. doi: 10.1007/s00134-007-0789-6. Epub 2007 Jul 21.