Trial reportCritical care (London, England)2023
Effect of propranolol and clonidine after severe traumatic brain injury: a pilot randomized clinical trial.
Trial report in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01322048 (DASH After TBI Study), which is not on this map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
DASH After TBI Study: Decreasing Adrenergic or Sympathetic Hyperactivity After Severe Traumatic Brain Injury, A Pilot Randomized Clinical Trial Using Propranolol and Clonidine
Who cites it
15 citing papers in PubMed, 21 citations in OpenAlex.
- Early Intravenous Beta-Blockade with Esmolol in Adults with Severe Traumatic Brain Injury: A Phase 2a Intervention Design Study.Neurocritical care · 2024Trial
- Hypothalamus Participates in Peripheral Sympathetic Hyperactivity After Acute Brain Injury by RegulatingMedComm · 2026Article
- Neuropharmacology in pediatric traumatic brain injury.Journal of pediatric rehabilitation medicine · 2026Review
- Article
- Beta-blockers in adults with acute traumatic brain injury: a systematic review and meta-analysis of randomized controlled trials.Journal of anesthesia, analgesia and critical care · 2025Review
- Cerebral fat embolism presenting as paroxysmal sympathetic hyperactivity.Trauma case reports · 2025Article
- Neurogenic organ dysfunction syndrome after acute brain injury.Military Medical Research · 2025Review
- Clinical effect of dexmedetomidine combined with landiolol hydrochloride on cerebral oxygen metabolism and inflammatory response in patients with severe craniocerebral injury.BMC anesthesiology · 2025Article
- High Priority Traumatic Brain Injury Science: Analysis of the National Trauma Research Action Plan.The Journal of surgical research · 2025Article
- Extracranial Effects of Traumatic Brain Injury: A Narrative Review.Clinics and practice · 2025Review
- High-temperature requirement serine protease A2 inhibitor UCF-101 ameliorates damaged neurons in traumatic brain-injured rats by the AMPK/NF-κB pathway.Open life sciences · 2025Article
- Feasibility study on intracranial pressure and prognosis of patients with moderate and severe craniocerebral injury using the Rotterdam computed tomography score: an observational study.Frontiers in neurology · 2025Article
- Article
- Dysregulated brain-gut axis in the setting of traumatic brain injury: review of mechanisms and anti-inflammatory pharmacotherapies.Journal of neuroinflammation · 2024Review
- Potential application of peripheral blood biomarkers in intracranial aneurysms.Frontiers in neurology · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 9 institutions in 2 countries.
Funding
Abstract
objectiveTo evaluate the safety, feasibility, and efficacy of combined adrenergic blockade with propranolol and clonidine in patients with severe traumatic brain injury (TBI).
backgroundAdministration of adrenergic blockade after severe TBI is common. To date, no prospective trial has rigorously evaluated this common therapy for benefit.
methodsThis phase II, single-center, double-blinded, pilot randomized placebo-controlled trial included patients aged 16-64 years with severe TBI (intracranial hemorrhage and Glasgow Coma Scale score ≤ 8) within 24 h of ICU admission. Patients received propranolol and clonidine or double placebo for 7 days. The primary outcome was ventilator-free days (VFDs) at 28 days. Secondary outcomes included catecholamine levels, hospital length of stay, mortality, and long-term functional status. A planned futility assessment was performed mid-study.
resultsDose compliance was 99%, blinding was intact, and no open-label agents were used. No treatment patient experienced dysrhythmia, myocardial infarction, or cardiac arrest. The study was stopped for futility after enrolling 47 patients (26 placebo, 21 treatment), per a priori stopping rules. There was no significant difference in VFDs between treatment and control groups [0.3 days, 95% CI (- 5.4, 5.8), p = 1.0]. Other than improvement of features related to sympathetic hyperactivity (mean difference in Clinical Features Scale (CFS) 1.7 points, CI (0.4, 2.9), p = 0.012), there were no between-group differences in the secondary outcomes.
conclusionDespite the safety and feasibility of adrenergic blockade with propranolol and clonidine after severe TBI, the intervention did not alter the VFD outcome. Given the widespread use of these agents in TBI care, a multi-center investigation is warranted to determine whether adrenergic blockade is of therapeutic benefit in patients with severe TBI. Trial Registration Number NCT01322048.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.