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Severe Traumatic Brain InjuryBELA TRIPPNCT05566431

Benchmark Evidence Led by Latin America: Trial of Intracranial Pressure - Pediatrics

A study testing ICP and CREVICE in people with Severe Traumatic Brain Injury, run by University of Washington at 11 sites in 6 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Narrative: Worldwide, traumatic brain injury (TBI) is a leading cause of death and disability among children and adolescents. The Investigators aim to test whether pediatric TBI treatment guided by invasive intracranial pressure monitoring produces better patient outcomes than care guided by a protocol without… Read more about this study

Who is it for?
Ages 1 year to 12 years
Conditions the study is for
Severe Traumatic Brain Injury
What is being tested?
ICP and CREVICE
Could I receive a placebo?
No, everyone receives an active treatment
How many people
428 participants
Where
11 sitesin 6 countries
Study dates
22 Mar 2023to 31 Jan 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 year to 12 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Provision of signed and dated informed consent form by the parent(s) or guardian(s)
  • Non-penetrating TBI
  • Admission to study hospital within 24 hours of injury
  • Total GCS score ≤ 8 on admission or within first 48 hours after injury (measured using pediatric GCS 1 for children < 2 years old and standard GCS for older children)
  • Age 1 through 12 years
  • Able to randomize:
  • Within 24 hours of injury (for patients with GCS ≤ 8 on admission) OR
  • Within 24 hours of deterioration (for patients deteriorating to GCS ≤ 8 within 48 hours of injury)

Who cannot join

  • Motor GCS score of 6
  • GCS of 3 with bilaterally fixed and dilated pupils
  • Injury thought to be intentionally inflicted by a family member or caregiver.

Trial locations and contacts

11 sites in 6 countries. Contact the study team or a site near you to ask about taking part.

Randall M Chesnut, MD contact

2067449322

chesnutr@uw.edu

Kelley Chaddock, BA contact

2067449322

chaddk@uw.edu

11 sites in 6 countries

Guatemala3 sites, 3 recruiting
  • Hospital Regional de Esquintla

    Escuintla

    Willy Menendez, MD, +502 5204 4531, menendezwilly@yahoo.com.mx

    Sophia Posadas, MD, +502 4063 0100, Sofia_posadas@yahoo.com

    Recruiting
  • Hospital General San Juan de Dios

    Guatemala City

    Maria del Carmen Castro, MD, +502 4255 2860, carmencd85@gmail.com

    Roberto Sierra, MD, +502 5439 8462, robertsierramorales@gmail.com

    Recruiting
  • Hospital Regional de Occidente San Juan de Dios

    Quetzaltenango

    Andrea Mazariegos, MD, 502 4154 9866, andre_mazar3@hotmail.com

    Elie de Leon, MD, + 502 50188332, elieneurology28@gmail.com

    Recruiting

Other trials in Guatemala

Peru3 sites, 3 recruiting
  • Hospital de Emergencias Pediátricas

    Lima

    Grimaldo C Ramirez, MD, +51 997 294 904, gramirezcortez61@gmail.com

    Yhuri Carreazo, MD, +51 997252543, yhuroc@gmail.com

    Recruiting
  • Hospital Edgardo Rebagliati Martins

    Lima

    Manuel Munaico, MD, 51948418590, munakusqayku@gmail.com

    Manuel Ortiz, MD, 51987817613, manortizch@hotmail.com

    Recruiting
  • Instituto Nacional de Salud del Niño - San Borja

    Lima

    Daniel Achante, MD, 51961090970, danielanchante@hotmail.com

    Patrick Caqui, MD, 51933160526, patrickdannycaquivilca@gmail.com

    Recruiting

Other trials in Peru

Colombia2 sites, 2 recruiting
  • Fundación Hospital de la Misericordia

    Bogotá

    Juan David Roa Giraldo, MD, 3013380506, Jdroag@gmail.com

    Wenci Camilo Navarro, MD, 3004576234, Camilosuescun18@gmail.com

    Recruiting
  • Hospital Fundacion Amigos de la Salud

    Montería

    Yojana Nova, MD, 57 3245819372, yonova12@gmail.com

    Antonio Macareno Atencia, MD

    Recruiting

Other trials in Colombia

United States1 site, 1 recruiting
  • University of Washington, Harborview Medical Center

    Seattle, Washington, 98104

    Not yet recruiting

Other trials in United States

El Salvador1 site, 1 recruiting
  • Hospital de Niños Benjamín Bloom

    San Salvador

    Luis J Guzman, MD, 503 7318 4077, licoguzman@yahoo.com.mx

    Melvin Moisa, MD, +503 7160 2879, melvin3_29@hotmail.com

    Recruiting

Other trials in El Salvador

Honduras1 site, 1 recruiting
  • Hospital Escuela

    Tegucigalpa

    Sandra Rodriguez, MD, 50499983875, sandra.rodriguez@unah.edu.hn

    Sandra Flores, MD, 50499077099, floresirias@yahoo.es

    Recruiting

Other trials in Honduras

About this study

Official title: Pediatric Severe Traumatic Brain Injury in Latin America - A Randomized Trial Comparing Two Management Protocols

Narrative:

Worldwide, traumatic brain injury (TBI) is a leading cause of death and disability among children and adolescents. The Investigators aim to test whether pediatric TBI treatment guided by invasive intracranial pressure monitoring produces better patient outcomes than care guided by a protocol without invasive monitoring. Study findings will inform clinical practice in treating pediatric severe TBI globally. Focused didactic and experience-based learning opportunities will increase the research capacity of pediatric intensivists in Latin America.

Read the detailed description

Abstract:

Children who survive severe traumatic brain injury (sTBI) live with profound impairments that alter their development and future possibilities. Worldwide, TBI is the leading cause of death and disability for children/ adolescents with the US annual incidence 6 times greater than MS, HIV/AIDS, spinal cord injury, and breast cancer combined.

Our primary focus for scientific investigation is to conduct a high quality randomized controlled trial addressing a critical TBI management question: Does using a protocol with information from intracranial pressure (ICP) monitoring to direct treatment of children with sTBI improve outcomes vs an aggressive management protocol based on imaging and clinical examination alone? This follows on our adult ICP study which found no outcome differences and has occasioned re-thinking of treatment guidelines for sTBI patients >13. A separate study is essential because children are not simply small adults and some treatment approaches carry age-related additional risks. Thus, study findings will inform US and global clinical practice.

This trial will be conducted in 8 Latin American pediatric ICUs where infrastructures and practice patterns are optimal for strong internal validity and resources represent trauma care in the developing world. The successful adolescent/adult BEST TRIP trial, which collected high-quality data in similar environments (cited > 900 times) underscores the feasibility of this approach.

Specific Aim: In a Phase III randomized superiority trial in 428 children with sTBI from 8 Latin American pediatric trauma centers, test the effect on outcomes of management of sTBI guided by a protocol using information from ICP monitors vs. management using a protocol that uses imaging and clinical exams to guide treatment.

Hypothesis #1: Children with severe TBI whose acute care treatment is managed using a protocol based on data from ICP monitoring will have significantly lower mortality and better quality of life and global outcome at 6 months post-trauma than those whose treatment is managed with a protocol based on imaging and clinical exam. The primary measure of functional recovery is the PedsQL at 6 months. A secondary measure is GOSE-Peds.

Hypothesis #2: Incorporating ICP monitoring into sTBI patient care will minimize secondary complications, decrease length of stay in ICU and decrease brain-specific treatments.

Specific Aim: The Investigators will train personnel in centers new to research how to conduct high-quality scientific studies, and will extend the training for the personnel with whom the Investigators have been working, solidifying previous capacity-building efforts, and initiating new efforts.

Being tested
ICP, CREVICE
Keywords
sTBI, ICP monitoring, randomized controlled trial, TBI management, Latin America, pediatric, Phase III
Medical subject headings
Brain Injuries, Traumatic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ICPOther

    Also called Intracranial-pressure-monitoring-based management protocol

    The intervention is a management protocol that includes ICP monitoring for children with severe traumatic brain injury

  • CREVICEOther

    Also called Imaging-and-clinical-examination-based management protocol

    The intervention is a management protocol that is based on imaging and clinical examinations without ICP monitoring for children with severe traumatic brain injury

Study groups in NCT05566431
Study groupRoleWhat they receive
ICP monitoring based ProtocolActive comparatorArm one will use a consensus-developed management protocol for paediatric severe traumatic brain injury based on recommendations from the Brain Trauma Foundation Guidelines, which uses invasive intracranial pressure monitoring
Receives: Other: ICP
No ICP Monitoring Protocol CREVICEActive comparatorArm two will use the Consensus-Revised Imaging and Clinical Examination (CREVICE) management protocol for paediatric severe traumatic brain injury based on imaging and clinical examination in the absence of invasive intracranial pressure monitoring
Receives: Other: CREVICE

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pediatric Quality of Life Inventory (PedsQL)

    PedsQL is a generic, health-related quality of life instrument developed to measure the core dimensions of physical, cognitive, mental, social health, and role (school) function. Minimum and maximum values: 0-100. Higher scores have better outcomes.

    Measured: 6 months after injury

Secondary outcomes (5)
  1. Pediatric Quality of Life Inventory (PedsQL)

    PedsQL is a generic, health-related quality of life instrument developed to measure the core dimensions of physical, cognitive, mental, social health, and role (school) function. Minimum and maximum values: 0 - 100. Higher the score means a better outcome.

    Measured: 3 months after injury

  2. Glasgow Outcome Scale - Extended (GOS-E) Pediatric

    GOS-E is the most common measure of functional outcome in adult TBI trials. Its pediatric version is the primary outcome in the NINDS-funded ADAPT study. Minimum and maximum values: 1-8. Higher score has worse outcomes.

    Measured: 3 and 6 months after injury

  3. Mortality

    Percent of participants who have died by the assessment time.

    Measured: 3 and 6 months

  4. Brain-specific interventions

    Total number of individual interventions directed at treating measured or suspected intracranial hypertension (i.e., brain-specific treatment) per hour summed over the duration of brain-specific treatment in ICU. Time Frame for brain-specific treatments is through acute hospitalization, an average of one (1) month and for GOS-E Peds is conducted 3 and 6 months after injury.

    Measured: 1 month average

  5. ICU length of stay

    ICU length of stay related to TBI management is through acute hospitalization and for an average of one (1) month.

    Measured: 1 month average

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Oct 2022
  2. Study start22 Mar 2023
  3. Primary completion31 Jan 2028 (estimated)
  4. Study completion31 Jan 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
In a Phase III multicenter, parallel-group, randomized superiority trial in 428 children with sTBI from 7 Latin American pediatric trauma centers, the objective is to test the efficacy of the treatment protocol from the Guidelines based on ICP monitoring among children with sTBI in improving global outcome measured by Pediatric Quality of Life Inventory (PedsQL) 6 mos after injury compared to treatment based on a non-invasive imaging \& clinical examination (CREVICE) protocol specifically modified for a pediatric population.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
428 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05566431
Sponsor's protocol ID
STUDY00013122
Other IDs
1R01HD106273-01
Acronym
BELA TRIPP
Status last verified
Jun 2025
First submitted
10 Jun 2022
Last updated
27 Jun 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: When the study is completed, access to study data may be provided through the UW Data Repository for future analyses about brain injury, its treatment, and outcomes or other scientifically appropriate questions. A de-identified dataset will be provided to successful candidates for the specified use.

Publications

  • Chesnut R, Temkin N, Pridgeon J, Sulzbacher S, Lujan S, Videtta W, Moya-Barquin L, Chaddock K, Bonow RH, Petroni G, Guadagnoli N, Hendrickson P, Ramirez Cortez G, Carreazo NY, Vargas Aymituma A, Anchante D, Caqui P, Ramirez A, Munaico Abanto M, Ortiz Chicchon M, Cenzano Ramos J, Castro Darce MDC, Sierra Morales R, Brol Lopez P, Menendez W, Posadas Gutierrez S, Kevin V, Mazariegos A, de Leon E, Rodas Barrios RE, Rodriguez S, Flores S, Alvarado O, Guzman Flores LJ, Moisa Martinez M, Gonzalez P. Development of a Randomized Trial Comparing ICP-Monitor-Based Management of Severe Pediatric Traumatic Brain Injury to Management Based on Imaging and Clinical Examination Without ICP Monitoring-Research Algorithms. Neurosurgery. 2024 Jan 1;94(1):72-79. doi: 10.1227/neu.0000000000002760. Epub 2023 Nov 13.

    PubMed 37955439
  • Chesnut R, Temkin N, Pridgeon J, Sulzbacher S, Lujan S, Videtta W, Moya-Barquin L, Chaddock K, Bonow R, Petroni G, Guadagnoli N, Hendrickson P, Ramirez Cortez G, Carreazo NY, Vargas Aymituma A, Anchante D, Caqui P, Ramirez A, Munaico Abanto M, Ortiz Chicchon M, Cenzano Ramos J, Mazate-Mazariegos A, Castro Darce MDC, Sierra Morales R, Brol Lopez P, Menendez W, Posadas Gutierrez S, Kevin V, Mazariegos A, de Leon E, Rodas Barrios RE, Rodriguez S, Flores S, Alvarado O, Guzman Flores LJ, Moisa Martinez M, Gonzalez P. Development of a Randomized Trial Comparing ICP-Monitor-Based Management of Severe Pediatric Traumatic Brain Injury to Management Based on Imaging and Clinical Examination Without ICP Monitoring-Study Protocol. Neurosurgery. 2024 Jan 1;94(1):65-71. doi: 10.1227/neu.0000000000002582. Epub 2023 Jul 6.

    PubMed 37409817

Questions about this trial

What is this clinical trial studying?

A study testing ICP and CREVICE in people with Severe Traumatic Brain Injury, run by University of Washington at 11 sites in 6 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 27 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in Guatemala, Peru, Colombia, United States, El Salvador and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Randall M Chesnut, MD (2067449322, chesnutr@uw.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pediatric Quality of Life Inventory (PedsQL) (time frame: 6 months after injury). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05566431, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jun 2025.

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