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HyperoxemiaHYPER-MINDNCT07377162

HYPER MIND - Hyperoxia Effects on Cerebral Hemodynamics

A study testing Normobaric Hyperoxic Stimulus (NBHO) in people with Hyperoxemia and Cerebrovascular Circulation, run by Erasme University Hospital at 1 site in Belgium.

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

This study aims to better understand how short periods of exposure to high oxygen levels affect blood flow in the brain of patients who are intubated and mechanically ventilated in the Intensive Care Unit (ICU). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Normobaric Hyperoxic Stimulus (NBHO)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteBelgium
Study dates
1 Jan 2024to 31 Dec 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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult patients aged ≥18 years
  • Admitted to the intensive care unit (ICU)
  • Intubated and mechanically ventilated for ≤72 hours
  • Receiving volume-controlled mechanical ventilation
  • Arterial partial pressure of carbon dioxide (PaCO₂) between 35 and 45 mmHg
  • Invasive arterial blood pressure monitoring in place
Show all 9Show fewer
  • Adequate transcranial Doppler (TCD) acoustic window
  • Clinically judged to be suitable for a brief normobaric hyperoxic stimulus
  • Expected to receive one or two hyperoxic steps based on baseline FiO₂ requirements: a) Baseline FiO₂ < 0.5: two-step hyperoxic stimulus (FiO₂ 0.5 followed by FiO₂ 1.0); b) Baseline FiO₂ ≥ 0.5: one-step hyperoxic stimulus (FiO₂ 1.0)

Who cannot join

  • Age <18 years
  • Pregnancy
  • Extracorporeal membrane oxygenation (ECMO)
  • Continuous renal replacement therapy (CRRT)
  • Contraindications to hyperoxia, as judged by the treating physician
  • Severe hemodynamic instability requiring changes in vasopressor dose during the recording period
  • Inability to obtain a reliable transcranial Doppler signal through the temporal acoustic windows
  • Any clinical condition deemed by the treating physician to pose unacceptable risk during hyperoxic exposure

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Michele Salvagno, MD contact

+32471386614

michele.salvagno@ulb.be

Belgium1 site, 1 recruiting
  • Erasme Hospital - ULB

    Brussels

    Michele Salvagno, MD, +32471386614, michele.salvagno1@gmail.com

    Recruiting

Other trials in Belgium

About this study

Official title: HYPERMIND - Hyperoxia Effects on Cerebral Hemodynamics

This study aims to better understand how short periods of exposure to high oxygen levels affect blood flow in the brain of patients who are intubated and mechanically ventilated in the Intensive Care Unit (ICU). Many ICU patients receive more oxygen than strictly necessary, and high blood oxygen levels (hyperoxemia) are very common. However, the immediate effects of short hyperoxic exposures on cerebral circulation and autoregulation remain poorly understood.

In this study, patients who already require mechanical ventilation for medical reasons will undergo a brief and controlled increase in the oxygen delivered through the ventilator (FiO₂). During this time, we will continuously monitor blood flow in one of the main brain arteries using a non-invasive ultrasound technique called transcranial Doppler (TCD). The goal is to evaluate how cerebral blood flow, pulsatility, and autoregulatory capacity change during and after a short hyperoxic stimulus.

No additional invasive procedures are required beyond standard ICU monitoring, except for the temporary adjustment of the ventilator's oxygen settings and arterial blood gas sampling, which are part of usual care in critically ill patients. Participation does not provide direct clinical benefit but may help improve future oxygen management in ICU patients. The study involves minimal risk, as short hyperoxic exposures are already common in routine care and will be interrupted immediately in case of any adverse event.

Read the detailed description

Patients will be studied under controlled mechanical ventilation with stable ventilatory, hemodynamic, and sedative settings. Continuous transcranial Doppler (TCD) monitoring will be performed using a 2-MHz probe insonating the middle cerebral artery through the temporal bone window. Cerebral blood flow velocity signals and arterial blood pressure waveforms will be recorded continuously for offline analysis.

The experimental protocol consists of stepwise increases in the fraction of inspired oxygen (FiO₂), according to baseline oxygen requirements. Patients with a baseline FiO₂ < 0.5 will undergo two consecutive hyperoxic steps (FiO₂ 0.5 followed by FiO₂ 1.0), whereas patients with a baseline FiO₂ ≥ 0.5 will undergo a single hyperoxic step (FiO₂ 1.0). Each hyperoxic step will include a stabilization period of approximately 5 minutes to allow attainment of a physiological steady state, followed by a 10-minute recording period dedicated to cerebral hemodynamic and autoregulation assessment. After completion of the hyperoxic exposure(s), FiO₂ will be returned to baseline values. In total, there will be 3 or 4 steps, depending on the baseline FiO₂.

Arterial blood gas samples will be obtained at baseline, at the end of each hyperoxic step, and after return to baseline oxygen settings to document changes in arterial oxygen and carbon dioxide tensions. Ventilation parameters, sedation, vasoactive drug infusion rates, and fluid therapy will be kept constant throughout the protocol whenever clinically feasible.

Cerebral hemodynamic assessment will include mean flow velocity, pulsatility index, and resistive index derived from TCD signals. Dynamic cerebral autoregulation will be evaluated using established indices (the mean flow index (Mxa), transfer function analysis (TFA) parameters, autoregulation index (ARI)), and metrics derived from spontaneous fluctuations in arterial blood pressure and cerebral blood flow velocity.

Analyses will primarily rely on paired statistical methods. Exploratory subgroup analyses according to baseline oxygen requirements, illness severity, or relevant comorbidities may be conducted.

Patient safety will be continuously monitored throughout the protocol, and the procedure will be immediately discontinued in case of any clinical instability, including hemodynamic deterioration, arrhythmias, or oxygenation abnormalities.

Being tested
Normobaric Hyperoxic Stimulus (NBHO)
Keywords
hyperoxemia, brain hemodynamics, tcd, cerebral autoregulation, Critical Illness, intensive care unit, hyperoxia, oxygen
Medical subject headings
Critical Illness, Choroideremia, Hyperoxia

What participants receive

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

  • Normobaric Hyperoxic Stimulus (NBHO)Other

    The intervention consists of a short, controlled increase in the inspired oxygen fraction (FiO₂) delivered by the mechanical ventilator. Depending on baseline FiO₂, patients will receive: Depending on baseline FiO₂, patients will receive:

    Two-step NBHO (baseline FiO₂ < 0.5): FiO₂ raised to 0.5 and then to 1.0 One-step NBHO (baseline FiO₂ ≥ 0.5): FiO₂ raised to 1.0 Each step includes 5 minutes to reach steady state followed by a 10-minute recording period. Cerebral blood flow velocity and autoregulation are continuously assessed using transcranial Doppler ultrasound.

Study groups in NCT07377162
Study groupRoleWhat they receive
Experimental: Hyperoxic StimulusExperimentalParticipants receive one or two brief normobaric hyperoxic (NBHO) stimuli during mechanical ventilation. The inspired fraction of oxygen (FiO₂) is transiently increased to 0.5 or 1.0 depending on baseline FiO₂ requirements. Cerebral blood flow and autoregulation are continuously monitored using transcranial Doppler ultrasound.
Receives: Other: Normobaric Hyperoxic Stimulus (NBHO)

What is being measured

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

  1. Change in Mean Flow Index (Mx) During Normobaric Hyperoxia

    Dynamic cerebral autoregulation will be assessed using the mean flow index (Mx), calculated as the moving Pearson correlation coefficient between mean arterial pressure (MAP) and mean middle cerebral artery (MCA) blood flow velocity measured by transcranial Doppler ultrasonography.

    The outcome will be reported as the absolute change in Mx from baseline, calculated as the average Mx value during normobaric hyperoxia minus the baseline average.

    Measured: Baseline (prior to hyperoxic exposure), during normobaric hyperoxia steps, assessed during the intervention period, and after returning to baseline (assessed up to 20 minutes)

Secondary outcomes (4)
  1. Change in Middle Cerebral Artery Cerebral Blood Flow During Normobaric Hyperoxia

    Cerebral hemodynamics will be assessed by transcranial Doppler ultrasonography of the middle cerebral artery (MCA). The cerebral blood flow velocity (cm/s) will be evaluated and analyzed as a change from baseline during normobaric hyperoxia. It will be expressed as the absolute change from baseline, calculated as the average value during the last 5 minutes of normobaric hyperoxia minus the baseline average.

    Measured: Baseline (prior to hyperoxic exposure), during normobaric hyperoxia, assessed during the intervention period (up to 30 minutes per study session), and after returning to baseline (assessed up to 20 minutes)

  2. Change in Autoregulation Index (ARI) During Normobaric Hyperoxia

    Cerebral autoregulation will also be evaluated using the Autoregulation Index (ARI) derived from transfer function-based step response analysis, expressed on a scale from 0 to 9. The outcome will be expressed as the absolute change from baseline during normobaric hyperoxia.

    Measured: Baseline (prior to hyperoxic exposure), during normobaric hyperoxia, assessed during the intervention period (up to 30 minutes per study session), and after returning to baseline (assessed up to 20 minutes)

  3. Change in Transfer Function Analysis Parameters During Normobaric Hyperoxia

    Transfer function analysis (TFA) between mean arterial pressure and middle cerebral artery blood flow velocity will be performed. Gain (cm/s/mmHg) will be analyzed in the low-frequency band (0.07-0.20 Hz). It will be expressed as absolute change from baseline during normobaric hyperoxia.

    Measured: Baseline (prior to hyperoxic exposure), during normobaric hyperoxia, assessed during the intervention period (up to 30 minutes per study session), and after returning to baseline (assessed up to 20 minutes)

  4. Change in Transfer Function Analysis Parameters During Normobaric Hyperoxia

    Description: Transfer function analysis (TFA) between mean arterial pressure and middle cerebral artery blood flow velocity will be performed. Phase (radians) will be analyzed in the low-frequency band (0.07-0.20 Hz). It will be expressed as absolute change from baseline during normobaric hyperoxia.

    Measured: Baseline (prior to hyperoxic exposure), during normobaric hyperoxia, assessed during the intervention period (up to 30 minutes per study session), and after returning to baseline (assessed up to 20 minutes)

Timeline

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

  1. First posted29 Jan 2026
  2. Study start1 Jan 2024
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 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
Basic science
Allocation
Not applicable
Intervention model
Single group
Model description
Participants will undergo one or two controlled hyperoxic stimuli depending on baseline FiO₂. All participants receive the same physiological intervention consisting of a brief increase in inspired oxygen fraction (FiO₂), with cerebral hemodynamics monitored using continuous transcranial Doppler. No randomization is performed.
Masking
None (open label)
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07377162
Sponsor's protocol ID
SRB2023205
Acronym
HYPER-MIND
Status last verified
Jan 2026
First submitted
11 Dec 2025
Last updated
29 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data (IPD) will not be shared because the data are collected within Hôpital Erasme - ULB and contain coded clinical information that cannot be transferred outside the institution according to local ethical and data protection policies. Only aggregated, non-identifiable results will be shared through scientific publications or presentations.

Questions about this trial

What is this clinical trial studying?

A study testing Normobaric Hyperoxic Stimulus (NBHO) in people with Hyperoxemia and Cerebrovascular Circulation, run by Erasme University Hospital at 1 site in Belgium.

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 9 inclusion and 8 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 29 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Belgium. 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 Michele Salvagno, MD (+32471386614, michele.salvagno@ulb.be), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Mean Flow Index (Mx) During Normobaric Hyperoxia (time frame: Baseline (prior to hyperoxic exposure), during normobaric hyperoxia steps, assessed during the intervention period, and after returning to baseline (assessed up to 20 minutes)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 29 Jan 2026.

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