This randomised, blinded, placebo-controlled, parallel-group pilot and feasibility trial (n=400) will investigate the efficacy and safety of using esketamine for the treatment of patients with severe acute brain injury. It will specifically focus on cortical spreading depolarisations (SDs), which occur frequently after traumatic brain injury (TBI), aneurysmal subarachnoid haemorrhage (aSAH), or intracerebral haemorrhage (ICH).
The trial, conducted by Rigshospitalet, Denmark, will include participants admitted to the neurointensive care unit with TBI, aSAH, or ICH and undergoing craniotomy or craniectomy. If clustered SDs occur despite physiological optimisation, the participants will be allocated 1:1 to infusion of S-ketamine or a matching placebo.
The primary outcome measure is the occurrence of SDs after randomisation, while secondary outcome measures include the rate of adverse events, functional outcome at 6 months post-randomisation, all-cause mortality, and other measures related to neurological worsening and the feasibility of the trial design. The study started in September 2023 and is expected to be completed by December 2026.
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Copenhagen University Hospital RigshospitaletThe university hospital in Copenhagen, the Rigshospitalet, is Denmark's most prestigious (and largest) hospital. Literally translated, the name stands for 'Hospital of the Realm.' Researchers here are working on at least three psychedelic trials with psilocybin.