Randomized Trial of Fludrocortisone Versus Placebo for Treatment in Adults With Aneurysmal Subarachnoid Hemorrhage in Critical Care
Led by The George Institute · Updated on 2025-12-16
524
Participants Needed
16
Research Sites
52 weeks
Total Duration
AI-Summary
What this Trial Is About
This research aims to evaluate whether early use of enteral fludrocortisone can reduce death and dependency six months after aneurysmal subarachnoid haemorrhage aSAH, a severe type of stroke that mainly affects adults aged 45 to 64 and more often women. The condition has a high mortality rate and many survivors face lasting neurological and cognitive problems, impacting their quality of life and ability to work. The study will address the need for better treatment options given the high healthcare costs and poor outcomes associated with aSAH.
Participants will be randomly assigned to receive either fludrocortisone or a matched placebo tablet every six hours by mouth for 14 days. Fludrocortisone is a synthetic steroid that helps retain sodium and fluids, potentially preventing hyponatraemia, a common and serious complication of aSAH that can worsen brain swelling and increase the risk of further brain injury. This trial is blinded and controlled to compare the effects of fludrocortisone against placebo in critically ill patients.
During the study, participants will be monitored in a critical care setting with regular assessments including neurological evaluations and laboratory tests. The main outcome measured will be the level of disability or recovery at six months using the Modified Rankin Scale. Additional assessments will include quality of life tools specific to subarachnoid haemorrhage. Safety and side effects will be closely observed throughout the study. The total duration of participation includes treatment and follow-up assessments up to six months after randomization.
CONDITIONS
Brief Title
FLudrocortisone Administration in Aneurysmal Subarachnoid Haemorrhage
Research Team
J
Jeremy Cohen, MBBS
D
Dorrilyn Rajbhandari, BN
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Diagnosed with aneurysmal subarachnoid haemorrhage confirmed by CTA or DSA imaging
Aneurysm has been secured
Hospital admission for aSAH within 96 hours
Currently being treated in a critical care environment
You will not qualify if you...
Unable to receive medications by mouth or feeding tube
Receiving glucocorticoid or mineralocorticoid treatment before the study
Previous allergic reaction to fludrocortisone
History of heart, liver, or kidney failure
Abnormal sodium levels (greater than 145 mmol/L or less than 125 mmol/L) on recent blood test
Death considered imminent or inevitable
Pregnancy confirmed or suspected
Previously participated in the FLASH trial
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - 14 days
Participants receive fludrocortisone or placebo tablets every 6 hours by mouth or feeding tube for 14 days while being treated in a critical care environment.
Daily visits during treatment in critical care
Follow-up
Duration - Up to 6 months
Participants are assessed for outcomes including neurological function and quality of life up to six months after treatment.
1 to 2 visits for outcome assessments
How is the study designed?
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
Fludrocortisone to treat patients with aneurysmal subarachnoid haemorrhage: Protocol for an international, phase 3, randomised, placebo-controlled, multicentre trial.