In the UK, 23,000 (15%) of the 150,000 people who suffer a stroke each year have bleeding in the brain, also referred to as acute intracerebral haemorrhage (ICH). An Autoregulation Index (ARI) can be assigned between 0 and 9 (0 being poor and 9 being the most efficient CA observed) to gauge how good the control over blood flow is at a given time. Dynamic CA (dCA) is a measure of the response of cerebral blood flow (CBF) to rapid changes in blood pressure (BP), and several key studies have shown impaired dCA post-acute ICH. The most recent study demonstrated that dCA impairment lasts up to 12 days. This is particularly important to understand, since our preliminary work has recently shown that changes in carbon dioxide using simple breathing exercises can improve Autoregulation. Unfortunately, there are limited non-pharmacological management options and significant opportunities to improve patient outcome in ICH. The proposed study addresses this area, by investigating whether a simple breathing exercise in survivors of ICH is safe, feasible and effective in reducing brain injury by improving cerebral autoregulation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
18
90 seconds of hyperventilation using a metronome to lower levels of -5mmHg and -10mmHg below baseline EtCO2
University Hospitals of Leicester NHS Trust
Leicester, United Kingdom
Post Stroke Morbidity and Mortality
Determined using Modified Rankin Scale 0 - No symptoms 1. \- No significant disability, despite symptoms; able to perform all usual duties and activities 2. \- Slight disability; unable to perform all previous activities but able to look after own affairs without assistance 3. \- Moderate disability; requires some help, but able to walk without assistance 4. \- Moderate severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance 5. \- Severe disability; bedridden, incontinent, and requires constant care 6- Death
Time frame: 14 days
The percentage of recruited subjects able to comply with the full measurement protocol
Time frame: 14 days
The percentage of measurements rejected because of aspects related to data quality during the analysis protocol, with recorded reasons
Time frame: 14 days
The percentage of recruited subjects in whom values for the following cerebral haemodynamic parameters can be derived
* % change in CBFv at baseline and in response to a hyperventilation manoeuvre in the acute (\<48 hours) and sub-acute (10 to 14 days) periods * Autoregulation index * % change in CBFv at baseline and in response to a hyperventilation manoeuvre in the acute (\<48 hours) and sub-acute (10 to 14 days) periods * Autoregulation index
Time frame: 14 days
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