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Brain Injuries, TraumaticOXY-TCNCT02754063

Impact of Early Optimization of Brain Oxygenation on Neurological Outcome After Severe Traumatic Brain Injury

A study testing PbtO2 probes and No PbtO2 probes in people with Brain Injuries, Traumatic, run by University Hospital, Grenoble at 26 sites in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Post-traumatic brain hypoxia/ischemia develops hours after traumatic brain injury (TBI), and its intensity is directly related to the neurological outcome. The thresholds for irreversible tissue damage following TBI indicate a particular vulnerability of injured brain. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Brain Injuries, Traumatic
What is being tested?
PbtO2 probes and No PbtO2 probes
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
320 participants
Where
26 sitesFrance
Study dates
Jun 2016to Apr 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age between 18 and 75
  • Severe non- penetrating TBI (GCS score 3-8) with motor Glasgow score between 1 and 5
  • Possible associated extracranial lesions, except tetraplegia
  • Initiation of cerebral monitoring within the first 16 hours since primary traumaticinjury
  • Indication of ICP monitoring on admission as part of the management
  • Indication of continuous sedation/analgesia for more than 48 hours
Show all 10Show fewer
  • Under mechanical ventilation with stable conditions: PaO2//FiO2 over 150 and PaCO2 between 35 and 45 mmHg, mean arterial pressure over 70 mmHg
  • Written informed consent from legal surrogate, patient's relative or investigator decision
  • Affiliation to the French Social Security or affiliated to a social security system of EU member state, Norway, Lichtenstein, Iceland or Switzerland
  • French-speaking or English-speaking patient

Who cannot join

  • Penetrating TBI
  • GCS 3 with bilateral fixed dilated pupils
  • Decompressive craniectomy and no repositioning of the bone flap after subdural hematoma evacuation surgery prior to enrolment
  • Contraindication of ICP and/or PbtO2 monitoring, i.e., hemostasis disorders and brain tissue infection
  • Persistent hemodynamic or respiratory instability despite treatments, i.e., mean arterial pressure < 70 mmHg, PaO2/FiO2 <150, PaCO2 <30 mmHg or >45 mmHg or lactate >5 mmol/l if available.
  • Hypothermia <34°C at randomization
Show all 16Show fewer
  • Life expectancy < 24 hours
  • Cardiac arrest at initial presentation
  • Tetraplegia
  • Neuropsychiatric co-morbidities that could interfere with 6 and 12-months assessment outcomes.
  • Consent refusal
  • Pregnancy
  • Participation in another therapeutic study with written consent
  • Inability to have a 6-months follow-up
  • Ischemic stroke after carotid arterial dissection
  • Incapacitated patients in accordance with article L 1121-5 to L1121-8 of the public health code.

Trial locations and contacts

26 sites in 1 country.

26 sites in 1 country

France26 sites
  • CHU Angers

    Angers

  • General Hospital of Annecy

    Annecy

  • University Hospital Besançon

    Besançon

  • University Hospital of Bordeaux

    Bordeaux

  • CHU CAEN

    Caen

  • University Hospital of Clermont-Ferrand

    Clermont-Ferrand

  • University Hospital of Dijon

    Dijon

  • Grenoble University Hospital

    Grenoble

  • University Hospital of Kremlin-Bicetre

    Le Kremlin-Bicêtre

  • University Hospital of Lille

    Lille

  • University Hospital of Lyon

    Lyon

  • University Hospital of Marseille-Nord

    Marseille

  • University Hospital of Marseille-Timone

    Marseille

  • University Hospital of Montpellier

    Montpellier

  • University Hospital of Nancy

    Nancy

  • University Hospital of Nice

    Nice

  • University Hospital of Nimes

    Nîmes

  • University Hospital of Paris-Salpetriere

    Paris

  • University Hospital of Poitiers

    Poitiers

  • University Hospital of Rennes

    Rennes

  • University Hospital of Rouen

    Rouen

  • University Hospital of St-Etienne

    Saint-Etienne

  • University Hospital Sud Réunion

    Saint-Pierre

  • University Hospital of Strasbourg

    Strasbourg

  • Hôpital d'Instruction des Armées

    Toulon

  • University Hospital of Toulouse

    Toulouse

Other trials in France

About this study

Post-traumatic brain hypoxia/ischemia develops hours after traumatic brain injury (TBI), and its intensity is directly related to the neurological outcome. The thresholds for irreversible tissue damage following TBI indicate a particular vulnerability of injured brain. Improving brain oxygenation after severe TBI is the focus of modern TBI management in the intensive care unit (ICU).

The calculation of cerebral perfusion pressure (CPP), with CPP = mean arterial pressure (MAP) - intracranial pressure (ICP), has become the most used estimator of cerebral blow flow. To prevent ischemia due to elevated ICP, current international guidelines recommend maintaining CPP at 60-70 mmHg and ICP below 20 mmHg. However, episodes of brain hypoxia/ischemia, as assessed with brain tissue oxygen pressure (PbtO2) measurements, might occur despite optimization of CPP and ICP, and have been independently associated with poorer patient outcome. PbtO2 values lower than 15 mmHg for more than 30 minutes were shown to be an independent predictor of unfavorable outcome and death. The aggressive treatment of low PbtO2 was associated with improved outcome compared to standard ICP/CPP-directed therapy in cohort studies of severely head-injured patients. On the basis of these findings, it is hypothesized that an early optimization of brain oxygenation, together with keeping ICP and CPP within recommended values, could reduce the volume of vulnerable lesions following severe TBI and possibly improve neurological outcome.

Being tested
PbtO2 probes, No PbtO2 probes
Medical subject headings
Brain Injuries, Traumatic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PbtO2 probesDevice

    PbtO2/ICP/CPP-directed therapy according to international recommendations

  • No PbtO2 probesOther

    ICP/CPP-directed therapy according to international recommendations

Study groups in NCT02754063
Study groupRoleWhat they receive
ICP ManagementActive comparatorNot described
Receives: Other: No PbtO2 probes
PbtO2 + ICP ManagementExperimentalNot described
Receives: Device: PbtO2 probes

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Neurological outcome according to the extended Glasgow Outcome Scale (GOSE) blind assessed

    Measured: at 6 months post-trauma

Secondary outcomes (6)
  1. Neurological outcome according to the extended Glasgow Outcome Scale (GOSE) and Disability Rating Scale

    Measured: at 12 months post-trauma (GOSE)

  2. Disability Rating Scale (DRS)

    Measured: at 6 and 12 months post-trauma

  3. Quality of life assessment: Functional Independence Measure (FIM) and Medical Outcomes Study Short-Form 12 (SF-12)

    Measured: at 6 and 12 months post-trauma

  4. Mortality rate

    Measured: at day 28

  5. Therapeutic intensity as reflected by the number of level 2 and level 3 treatments to treat elevated ICP

    Measured: during the first 5 days of the ICU stay

  6. Incidence of critical events as defined by: ICP >30 mmHg during 30 min at least ICP >40 mmHg during 5 min at least PbtO2 <10 mmHg during 30 min at least (PbtO2 group)

    Measured: during the first 5 days of the ICU stay

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Apr 2016 (estimated)
  2. Study startJun 2016
  3. Primary completion17 Oct 2021
  4. Study completionApr 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
320 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02754063
Sponsor's protocol ID
38RC14.039
Acronym
OXY-TC
Status last verified
May 2022
First submitted
15 Apr 2016
Last updated
18 May 2022
Results posted
No
Data monitoring committee
Yes

Publications

  • Cunningham AS, Salvador R, Coles JP, Chatfield DA, Bradley PG, Johnston AJ, Steiner LA, Fryer TD, Aigbirhio FI, Smielewski P, Williams GB, Carpenter TA, Gillard JH, Pickard JD, Menon DK. Physiological thresholds for irreversible tissue damage in contusional regions following traumatic brain injury. Brain. 2005 Aug;128(Pt 8):1931-42. doi: 10.1093/brain/awh536. Epub 2005 May 11.

    PubMed 15888537
  • Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS; Bratton SL, Chestnut RM, Ghajar J, McConnell Hammond FF, Harris OA, Hartl R, Manley GT, Nemecek A, Newell DW, Rosenthal G, Schouten J, Shutter L, Timmons SD, Ullman JS, Videtta W, Wilberger JE, Wright DW. Guidelines for the management of severe traumatic brain injury. IX. Cerebral perfusion thresholds. J Neurotrauma. 2007;24 Suppl 1:S59-64. doi: 10.1089/neu.2007.9987. No abstract available.

    PubMed 17511547
  • Oddo M, Levine JM, Mackenzie L, Frangos S, Feihl F, Kasner SE, Katsnelson M, Pukenas B, Macmurtrie E, Maloney-Wilensky E, Kofke WA, LeRoux PD. Brain hypoxia is associated with short-term outcome after severe traumatic brain injury independently of intracranial hypertension and low cerebral perfusion pressure. Neurosurgery. 2011 Nov;69(5):1037-45; discussion 1045. doi: 10.1227/NEU.0b013e3182287ca7.

    PubMed 21673608
  • van den Brink WA, van Santbrink H, Steyerberg EW, Avezaat CJ, Suazo JA, Hogesteeger C, Jansen WJ, Kloos LM, Vermeulen J, Maas AI. Brain oxygen tension in severe head injury. Neurosurgery. 2000 Apr;46(4):868-76; discussion 876-8. doi: 10.1097/00006123-200004000-00018.

    PubMed 10764260
  • Stiefel MF, Spiotta A, Gracias VH, Garuffe AM, Guillamondegui O, Maloney-Wilensky E, Bloom S, Grady MS, LeRoux PD. Reduced mortality rate in patients with severe traumatic brain injury treated with brain tissue oxygen monitoring. J Neurosurg. 2005 Nov;103(5):805-11. doi: 10.3171/jns.2005.103.5.0805.

    PubMed 16304983
  • Narotam PK, Morrison JF, Nathoo N. Brain tissue oxygen monitoring in traumatic brain injury and major trauma: outcome analysis of a brain tissue oxygen-directed therapy. J Neurosurg. 2009 Oct;111(4):672-82. doi: 10.3171/2009.4.JNS081150.

    PubMed 19463048
  • Payen JF, Vilotitch A, Gauss T, Adolle A, Bosson JL, Bouzat P; OXY-TC trial collaborators. Sex Differences in Neurological Outcome at 6 and 12 Months Following Severe Traumatic Brain Injury. An Observational Analysis of the OXY-TC Trial. J Neurotrauma. 2025 Jun;42(11-12):974-984. doi: 10.1089/neu.2024.0390. Epub 2025 Jan 23.

    PubMed 39846855
  • Payen JF, Launey Y, Chabanne R, Gay S, Francony G, Gergele L, Vega E, Montcriol A, Couret D, Cottenceau V, Pili-Floury S, Gakuba C, Hammad E, Audibert G, Pottecher J, Dahyot-Fizelier C, Abdennour L, Gauss T, Richard M, Vilotitch A, Bosson JL, Bouzat P; OXY-TC trial collaborators. Intracranial pressure monitoring with and without brain tissue oxygen pressure monitoring for severe traumatic brain injury in France (OXY-TC): an open-label, randomised controlled superiority trial. Lancet Neurol. 2023 Nov;22(11):1005-1014. doi: 10.1016/S1474-4422(23)00290-9.

    PubMed 37863590
  • Mistral T, Roca P, Maggia C, Tucholka A, Forbes F, Doyle S, Krainik A, Galanaud D, Schmitt E, Kremer S, Kastler A, Tropres I, Barbier EL, Payen JF, Dojat M. Automated Quantification of Brain Lesion Volume From Post-trauma MR Diffusion-Weighted Images. Front Neurol. 2022 Feb 23;12:740603. doi: 10.3389/fneur.2021.740603. eCollection 2021.

    PubMed 35281992
  • Payen JF, Richard M, Francony G, Audibert G, Barbier EL, Bruder N, Dahyot-Fizelier C, Geeraerts T, Gergele L, Puybasset L, Vigue B, Skaare K, Bosson JL, Bouzat P. Comparison of strategies for monitoring and treating patients at the early phase of severe traumatic brain injury: the multicentre randomised controlled OXY-TC trial study protocol. BMJ Open. 2020 Aug 20;10(8):e040550. doi: 10.1136/bmjopen-2020-040550.

    PubMed 32820002

Questions about this trial

What is this clinical trial studying?

A study testing PbtO2 probes and No PbtO2 probes in people with Brain Injuries, Traumatic, run by University Hospital, Grenoble at 26 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 26 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Neurological outcome according to the extended Glasgow Outcome Scale (GOSE) blind assessed (time frame: at 6 months post-trauma). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02754063, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2022.

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