This is a prospective, randomized, two-arm, controlled 30-day investigational pilot trial using the gammaCore Sapphire S non-invasive vagus nerve stimulation (nVNS) device + standard of care (SOC) in newly-hospitalized patients with mild-to-moderate traumatic brain injury (TBI) to prevent the progression towards immunokine storms, systemic inflammatory response syndrome (SIRS), severe respiratory distress, and requirement for invasive mechanical ventilation, and death, when compared to SOC alone (the control arm).
A pilot population of 46 individuals between 18-80 years of age inclusive, will be enrolled, with an in-trial monitoring period of up to 30 days following baseline measurements. Study subjects will remain in-trial until one of the following occurs: a) 30 days without any progression to respiratory distress requiring mechanical ventilation; b) requirement for mechanical ventilation prior to 30 days; or c) death prior to 30 days. In addition to the screening, a total of up to 5 additional in-trial events (depending on the time at discharge from hospitalization) plus one additional clinical site visit at the end of the follow-up period will comprise the study events schedule of this trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
3
AHN Allegheny General Hospital
Pittsburgh, Pennsylvania, United States
Days free of invasive mechanical ventilation
Days free of invasive mechanical ventilation within 30 days from baseline among TBI survivors.
Time frame: 30 days from baseline
Days free of death
Days free of death within 30 days from baseline
Time frame: 30 days from baseline
Adverse Events/Serious Adverse Events (AEs/SAEs)
Incidence, rate and severity of AEs/SAEs
Time frame: Day 30 from baseline, Day 60, Day 90
Incidence of abnormal Physical examinations
Physical examination results
Time frame: Day 30 from baseline or last day in hospital, Day 60, Day 90
Incidence of abnormal vital signs
vital sign results
Time frame: Day 30 from baseline or last day in hospital, Day 60, Day 90
Incidence of abnormal laboratory results
laboratory results
Time frame: Day 30 from baseline or last day in hospital, Day 60, Day 90
All-cause mortality
All-cause mortality
Time frame: Day 30 from baseline, Day 60, Day 90
Days free of organ failure
assessed using the Sequential Organ Failure Assessment (SOFA) score (numerically quantifies (0-4) the number and severity of failed organs) with higher number being worse
Time frame: Day 30 from baseline or last day in study, Day 60, Day 90
Days free of renal support
Time frame: Day 30 from baseline or last day in study
Days free of vasoactive support
Time frame: Day 30 from baseline or last day in study
Number of ICU-free days
assessed at Day 30 or on the last day in the ICU if the patient leaves the ICU before Day 30
Time frame: Day 30 from baseline
Days free of invasive mechanical ventilation
Time frame: Day 30 from baseline of last day in study
Length of hospital stay
Number of days in hospital
Time frame: Study Completion (up to 95 days from baseline)
Forced Expiratory Volume (FEV1)
Time frame: Day 30 from baseline, Day 60 from baseline, Day 90 from baseline
Neurological functioning
6 minute walk test
Time frame: Day 30 from baseline, Day 60 from baseline, Day 90 from baseline
PROMIS CAT score (Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT))
0 to 100, with 0 being the lowest physical function and most disabled and 100 having the highest functioning
Time frame: Day 30 from baseline, Day 60 from baseline, Day 90 from baseline
Post concussion symptom scale (PCSS)
27 perceived symptoms, patient reports their current experience of symptoms, on a scale from 0 to 6, with 0 being "none/not experiencing particular symptom" to 6 being experiencing "severe" symptom; total point value of scale is from 0 to 162
Time frame: Day 30 from baseline, Day 60 from baseline, Day 90 from baseline
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.