Advertisement

Topics

Weight Approximation in Stroke Before Thrombolysis

2014-08-27 03:18:15 | BioPortfolio

Summary

Thrombolysis using Alteplase (tPA) is still the only approved specific therapy for acute ischemic stroke (AIS). Current guidelines in western countries recommend an tPA dose of 0.9mg/kg up to a maximum dose of 90mg for patients weighing more than 100kg. However, larger dose-finding rtPA trials for intravenous thrombolysis in AIS are missing. Based on results from research on myocardial infarction only a few open label studies with low case rates were initiated to evaluate the optimal dose for tPA in cerebral ischemia. These studies suggested a narrow therapeutic range with decreased efficacy in lower dosages and an increased risk for thrombolysis related intracerebral hemorrhage (ICH) at doses above 0.95mg/kg. The ECASS-1 trial which used a dosage of 1.1mg/kg rt-PA showed significantly higher rate of large parenchymal hemorrhages compared to trials using 0.9mg/kg. Therefore accurate dosing is crucial. In the acute phase two aspects complicate rtPA dosing in AIS: First, unlike in other diseases many stroke patients are unable to communicate information on their body weight (BW) because of their stroke symptoms (e.g. aphasia, decreased consciousness). In addition motor symptoms prohibit easy weighing procedures in many patients. Second, the ultra-early and narrow time window for treatment does not allow time loss to weigh each patient in the emergency situation. Therefore routinely the attending physician has to make a visual estimation of the patient's BW. This may be inaccurate and may cause dosing errors which has been shown for other weight based emergency medication. There is little data on tPA-dosing errors in stroke patients and prospective data are lacking. The aim of our study is to evaluate availability of BW-information, accuracy of estimations and final dosing of tPA in a routine clinical setting. Therefore the investigators evaluate different sources of body weight estimations and also compare visual estimation with recently proposed anthropometric measurements for body weight approximation. Finally, impact of dosing errors on safety and efficacy are analyzed.

The initial phase will consist of 100 enrolled patients as a pilot phase for further power calculations. Based on the results of the pilot phase enrollment will continue. The envisioned inclusion target is up to 800 patients.

Study Design

Observational Model: Cohort, Time Perspective: Prospective

Conditions

Stroke

Intervention

Recording of body weight estimations, approximations and tPA dose

Location

Universityhospital Erlangen, Dept. of Neurology
Erlangen
Bavaria
Germany
91054

Status

Recruiting

Source

University of Erlangen-Nürnberg Medical School

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:18:15-0400

Clinical Trials [3377 Associated Clinical Trials listed on BioPortfolio]

Optimization of Contrast Agent Dose in CT With Lean Body Weight

This study evaluates the different enhancement using a contrast agent dose in computed tomography based on total body weight or based on lean body weight. Half of participants will receive...

rTMS Combined With BWSTT in Stroke With Body Weight Supported Treadmill Training (BWSTT) After Stroke

The study will enroll 5 individuals post-stroke to examine the feasibility and efficacy of a high frequency repetitive transcranial magnetic stimulation (rTMS) combined with body weight su...

Swipe Out Stroke (SOS): Feasibility of Using a Consumer Based Electronic Application to Improve Compliance With Weight Loss in Obese Minority Stroke Patients

This pilot study evaluates the use of a mobile application to improve weight loss in obese stroke patients. The investigators hypothesize that acute stroke patients who use the mobile appl...

Locomotor Experience Applied Post Stroke Trial

The purpose of this study is to compare two different treatments to improve walking after stroke (or post-stroke).

Stanford Healthy Heart Study

People with elevated blood pressure are at higher risk of having a heart attack or stroke than people with lower blood pressure. Losing a modest amount of weight—such as 15 or 20 pounds...

PubMed Articles [14489 Associated PubMed Articles listed on BioPortfolio]

Equations to estimate prednisone dose using body weight.

In the clinical practice, prednisone (PDN) dose in children is often prescribed using the patient weight, despite dose calculation using body surface area (BSA) is assumed to be preferable, because it...

Body Weight-Based Protocols During Whole Body FDG PET/CT Significantly Reduces Radiation Dose without Compromising Image Quality:Findings in a Large Cohort Study.

To investigate radiation dose reduction during whole body fluorodeoxyglucose (F-FDG) positron emission tomographic (PET)/computed tomography (CT) by employing weight-based protocols.

The influence of exercise training dose on fasting acylated ghrelin concentration in older women.

This study investigated if exercise dose affected acylated ghrelin response to exercise training, and how body weight or fat mass changes might affect the responses. Non-obese older women (n = 49)...

Non-weight-related body image concerns and Body Dysmorphic Disorder prevalence in patients with Anorexia Nervosa.

Patients with Anorexia Nervosa (AN) and patients with Body Dysmorphic Disorder (BDD) are both characterized by body image disturbance and dissatisfaction; furthermore, these disorders share clinical f...

Validation and application of a fast Monte Carlo algorithm for assessing the clinical impact of approximations in analytical dose calculations for pencil beam scanning proton therapy.

Monte Carlo (MC) dose calculation is generally superior to analytical dose calculation (ADC) used in commercial TPS to model the dose distribution especially for heterogeneous sites, such as lung and ...

Medical and Biotech [MESH] Definitions

Sustaining BODY WEIGHT after BODY WEIGHT CHANGES have been achieved.

A condition caused by the failure of body to dissipate heat in an excessively hot environment or during PHYSICAL EXERTION in a hot environment. Contrast to HEAT EXHAUSTION, the body temperature in heat stroke patient is dangerously high with red, hot skin accompanied by DELUSIONS; CONVULSIONS; or COMA. It can be a life-threatening emergency and is most common in infants and the elderly.

Expected weight of a healthy normal individual based on age, sex, and height. Thus, a malnourished person would weigh less than their ideal body weight.

An indicator of body density as determined by the relationship of BODY WEIGHT to BODY HEIGHT. BMI=weight (kg)/height squared (m2). BMI correlates with body fat (ADIPOSE TISSUE). Their relationship varies with age and gender. For adults, BMI falls into these categories: below 18.5 (underweight); 18.5-24.9 (normal); 25.0-29.9 (overweight); 30.0 and above (obese). (National Center for Health Statistics, Centers for Disease Control and Prevention)

The dose amount of poisonous or toxic substance or dose of ionizing radiation required to kill 50% of the tested population.

More From BioPortfolio on "Weight Approximation in Stroke Before Thrombolysis"

Advertisement
Quick Search
Advertisement
Advertisement

 

Relevant Topics

Neurology - Central Nervous System (CNS)
Alzheimer's Disease Anesthesia Anxiety Disorders Autism Bipolar Disorders Dementia Epilepsy Multiple Sclerosis (MS) Neurology Pain Parkinson's Disease Sleep Disorders Neurology is the branch of me...

Stroke - Cerebrovascular Disease (CVA)
A stroke is a serious medical condition that occurs when the blood supply to part of the brain is cut off. Strokes are a medical emergency and prompt treatment is essential because the sooner a person receives treatment for a stroke, the less damage is ...


Searches Linking to this Trial