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CompletedNCT04933448Updated Feb 12, 2026

Ketogenic Diet Following Moderate to Severe Pediatric Traumatic Brain Injury

An interventional study of Ketogenic Diet in Traumatic Brain Injury, sponsored by Gillette Children's Specialty Healthcare. Completed at 2 sites in United States. Open to participants aged 2 Years to 17 Years. Per ClinicalTrials.gov, last updated 2026-02-12.

Sponsored by Gillette Children's Specialty Healthcare · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
7
Allocation
Non-randomized
Ages
2 Years to 17 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 908 studies in Brain Injuries, Traumatic with a site in United States — 211 open to participants now, 249 under way, 5 of them phase 3. Brain Injuries, Traumatic · United States.

Enrollment
584th of 649
7 · median 50
Started
2022
with 32 others
No phase
440 of 908
110 open now
Registered
656th of 908
by date

Among the 908 studies in Brain Injuries, Traumatic with a site in United States, this one is the 584th largest by enrollment of the 649 interventional ones that give a count, is one of 33 that started in 2022, is one of 440 with no phase, and was the 656th registered.

Brain Injuries, Traumatic

1,721 studies on the registry are indexed under Brain Injuries, Traumatic; 447 are open to participants now.

Browse Brain Injuries, Traumatic studies →

Open to participants now

211 of the 908 studies in Brain Injuries, Traumatic with a site in United States are open now. Recruiting first, the newest first:

206 more — sign in →

All 211 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 281 Brain Injuries, Traumatic studies recruiting now, 120 (43%) set no upper age limit and 119 (42%) stop at 75 or younger; 40 take children under 18; 52 take healthy volunteers.

This study: 2 Years to 17 Years · all sexes · no healthy volunteers.

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02

Study summary

The primary objective of this study is to evaluate the feasibility and safety of using the ketogenic diet (KD) in children who sustained moderate to severe traumatic brain injury (TBI). The secondary objective is a preliminary evaluation of the outcomes of children who have had the standard of care plus the KD, compared to those with standard of care alone. Outcome measures for the secondary objective will include: need for ventriculoperitoneal shunt, duration of unconsciousness, need for any type of craniotomy, duration of post-traumatic amnesia, acute hospitalization length of stay, and cognitive and motor function at 12 months after injury. If this study demonstrates feasibility and safety, the information related to outcomes will be used to inform the planning of a future, larger, randomized study of the efficacy of the KD in children and adolescents with TBI. Specifically, this information will be used to assist with sample size calculations for this future study.

Read the detailed description

The KD is an alternative feeding regimen that has been in use since 1921. It is a high fat, low carbohydrate and moderate protein diet. There are various forms of the KD. The classic KD consists of long-chain triglycerides with a fat-to-combined-protein-and-carbohydrate ratio that can vary. At our institution, it is standard of care to initiate a ketogenic diet at a ratio of 2:1, and to increase the ratio to 3:1 or 4:1 as needed to achieve ketosis. Clinically, the KD has been proven to be an effective therapy in children and adolescents with refractory epilepsy, as well as for those with type II diabetes. In addition, an international consensus was published in 2009 that recommended the use of the KD to treat epilepsy refractory as an alternative to at least two antiepileptic medications. Before initiating the KD for epilepsy management, labs such as urine and blood ketones, blood glucose and a basic metabolic panel including magnesium are commonly recommended. Risks for long-term use of the KD include but are not limited to the following: hypercholesterolemia, mineral deficiencies, acidosis, constipation, weight loss and nephrolithiasis. However, short-term use should significantly limit the occurrence of these potential complications.

03

Conditions studied

  • Traumatic Brain Injury
04

Who can participate

Ages eligible
2 Years to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age limits met at the time of injury and admission
  • Participants with moderate to severe traumatic brain injury defined as a Glasgow Coma Scale Score of 3-12 (lowest score in the first 24 hours after injury). Individuals requiring craniotomy and/or evacuation of intracranial hemorrhage may be included.

Exclusion criteria

Exclusion Criteria:

  • Currently on an oral diet at time of screening or currently on IV-only and in opinion of Pediatric Intensive Care Unit intensivist will be transitioning to an oral diet, not tube-feeding
  • Anoxia/ischemia as a significant portion of injury, including near-drowning
  • Non-accidental traumatic brain injury (i.e., assault, abuse)
  • Penetrating injury including gunshot wounds
  • Pregnancy
  • Any condition that in the opinion of the Pediatric Intensive Care Unit or neurosurgery medical staff warrants exclusion from the study
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Single group
Masking
Single (Outcomes assessor)
Enrollment
7 participants (actual)

Study arms

  • Experimental
    Prospective Intervention Group

    Participants will receive standard of care for acute management of moderate to severe traumatic brain injury, together with a weight-based ketogenic diet added for up to fourteen days.

    Other: Ketogenic Diet

  • No intervention
    Historical Control Group

    Medical records of past TBI patients will be used as controls matched for age, gender, socioeconomic status (type of health care coverage including private insurance vs. government-funded coverage), lowest first 24 hour post-injury Glasgow Coma Score (GCS) (\<8 or 8-12), and pre-injury school program (regular or special education).

Interventions

  • OtherKetogenic Diet

    The ketogenic diet (KD) is an alternative feeding regimen that has been in use since 1921. It is a high-fat, low carbohydrate, and moderate protein diet. There are various forms of the KD. The classic KD consists of long-chain triglycerides with a fat-to-combined-protein-and-carbohydrate ratio that can vary. At the investigating institution, it is standard of care to initiate a ketogenic diet at a ratio of 2:1, and to increase the ratio to 3:1 or 4:1 as needed to achieve ketosis.

    Also known as: Keto

06

What researchers measure

Primary outcomes

  1. Ability to complete a course of the ketogenic diet (KD)

    Safety and feasibility will be determined by the ability to complete a 14-day course of the KD after TBI without needing to terminate the diet due to intolerance resulting from gastrointestinal side effects (for example, nausea and vomiting, diarrhea, or acidosis), or due to abnormal findings on laboratory tests. Outcome is reported as the number of participants who complete the 14-day keto diet treatment.

    Time frame: 14 days

Secondary outcomes

  1. Duration of Unconsciousness

    Outcome is reported as the length of time (in hours) a participant is unconscious following their injury.

    Time frame: 14 days

  2. Need for Surgeries

    Outcome is reported as the number of surgeries required in each group following injury.

    Time frame: 14 days

  3. Duration of Acute Hospitalization

    Outcome is reported as the length (in days) of acute hospitalization following injury.

    Time frame: 14 days

  4. Duration of Post-traumatic Amnesia

    Outcome is reported as the length of time (in days) that a participant experiences amnesia following their injury.

    Time frame: 14 days

07

Study locations

2 sites
  • Children's Minnesota
    Minneapolis, Minnesota 55404, United States
  • Gillette Children's Specialty Healthcare
    Saint Paul, Minnesota 55101, United States
08

References and documents

Individual participant data

Plan to share: No — pilot, feasibility study only.

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from May 2022 to primary completion in Dec 2024, 31 months.

Of 442 non-industry interventional studies with no phase under Brain Injuries, Traumatic, half reached primary completion within 41 months of starting (the median), counting those still running; a quarter within 23 and three quarters within 64. This study's 31 months is below that.

Counting every sponsor, half of 464 studies reached it within 40 months; a quarter within 22 and three quarters within 64.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 17, 2021
First posted
Jun 21, 2021
StartActual
May 16, 2022
Primary completionActual
Dec 31, 2024
CompletionActual
Dec 31, 2024
Last update
Feb 12, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 12, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04933448
Lead sponsor
Gillette Children's Specialty Healthcare
Collaborators
State of Minnesota Spinal Cord Injury and Traumatic Brain Injury Research Grant Program
Responsible party
Sponsor
First posted
Jun 21, 2021
Start date
May 16, 2022
Primary completion
Dec 31, 2024
Completion
Dec 31, 2024
Last update
Feb 12, 2026

Study contacts

Linda Krach, MD
principal investigator · Department of Physical Medicine and Rehabilitation
Angela Sinner, DO
principal investigator · Department of Physical Medicine and Rehabilitation

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.

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