Hypothermia in Children After Trauma

NCT ID: NCT00222742

Last Updated: 2012-07-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-11-30

Study Completion Date

2012-03-31

Brief Summary

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The primary hypothesis for this application for a multicenter phase III randomized clinical trial (RCT) is that induced moderate hypothermia (HYPO) (32-33 °C) after severe traumatic brain injury (TBI) in children and maintained for 48 hours will improve mortality at 3 months and 12 month functional outcome as assessed by the Glasgow Outcome Scale (GOS).

Detailed Description

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The primary specific aim of this RCT is to determine the effect of induced moderate HYPO (32-33 °C) after severe TBI in children on mortality at 3 months post injury. The primary outcome measure will be the GOS; the primary time point for evaluation is 3 months. Further secondary functional outcome measures will include the GOS - Extended Pediatrics (GOS - E Peds), and Vineland Adaptive Behavior Scale (VABS) and will be assessed in conjunction with the GOS at 6 and 12 months post injury.

The secondary hypotheses are based on the results and analysis of the Pilot Clinical Trial (completed and recently published \[Adelson et al. NEUROSURGERY. 56 (4): 740-754, 2005\]). These secondary hypotheses include that induced moderate hypothermia (HYPO) (32-33 °C) after severe TBI in children and maintained for 48 h:

* will improve other outcome assessments including neurocognitive status on performance-based neuropsychological testing across the domains of intellectual development, learning and memory, language, motor and psychomotor skills, visuo-spatial abilities, attention and executive function, and behavior at only 6 and 12 months after injury;
* HYPO will improve long term outcome of all age ranges and across genders in infants, young, preadolescent, and adolescent children; AND
* HYPO will lessen intracranial hypertension and lessen the intensity of therapy necessary for control of ICP.

Based on these hypotheses, further secondary specific aims are proposed:

* Specific Aim 2: To determine the effect of early induced moderate HYPO (32-33°C) after severe TBI in children on global function and neurocognitive outcomes in the areas of intellectual ability/ development, memory and learning, and behavior at 6 and 12 months post injury.
* Specific Aim 3: To determine the effect of early induced moderate HYPO after severe TBI in children of different age ranges (\< 6 y and 6- \< 16 y) on mortality and 6 and 12 months functional and neurocognitive outcomes.
* Specific Aim 4: To determine the effect of early moderate HYPO after severe TBI in children on reducing intracranial hypertension and maintaining adequate cerebral perfusion pressure (CPP).

Conditions

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Traumatic Brain Injury

Keywords

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hypothermia pediatric TBI

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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A

Induced moderate hypothermia (32-33 C)

Group Type EXPERIMENTAL

induced moderate hypothermia

Intervention Type PROCEDURE

Subjects assigned to the treatment arm will be cooled to 32-33 °C for 48 hours and then slowly warmed.

Interventions

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induced moderate hypothermia

Subjects assigned to the treatment arm will be cooled to 32-33 °C for 48 hours and then slowly warmed.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Patients with a GCS \</= 8
2. Glasgow Motor Score \< 6
3. Closed head injury
4. Age 0 \< 18 y

Exclusion Criteria

1. Unavailable to initiate cooling within 6 hours of injury
2. Glasgow Coma Scale (GCS) score = 3 and abnormal brainstem function
3. Normal initial CT scan (No blood, fracture, swelling, and/or shift)
4. Penetrating brain injury
5. No known mechanism of injury
6. Unknown time of injury
7. Uncorrectable coagulopathy (PT/PTT \> 16/40 sec, INR \> 1.7)
8. Hypotensive episode (Systolic Blood Pressure \<5th percentile for age\>10 min)
9. Documented Hypoxic episode (O2 saturation \< 94% for \> 30 min)
10. Pregnancy
Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

Phoenix Children's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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P. David Adelson, MD

Role: PRINCIPAL_INVESTIGATOR

Phoenix Children's Hospital

Locations

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Phoenix Childrens Hospital

Phoenix, Arizona, United States

Site Status

University of California, Davis Medical Center

Sacramento, California, United States

Site Status

Children's National Medical Center

Washington D.C., District of Columbia, United States

Site Status

University of Miami

Miami, Florida, United States

Site Status

Mayo Clinic in Rochester

Rochester, Minnesota, United States

Site Status

Washington University

St Louis, Missouri, United States

Site Status

Cohen's Children's Hospital

New Hyde Park, New York, United States

Site Status

Weill Cornell Medical Center

New York, New York, United States

Site Status

Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

Duke University

Durham, North Carolina, United States

Site Status

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

Site Status

Nationwide Children's Hospital

Columbus, Ohio, United States

Site Status

Penn State Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

University of Pittsburgh/Children's Hospital of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

University of Texas, Southwestern

Dallas, Texas, United States

Site Status

University of Washington

Seattle, Washington, United States

Site Status

Sydney Children's Hospital, Randwick

Sydney, New South Wales, Australia

Site Status

Children's Hospital at Westmead

Westmead, New South Wales, Australia

Site Status

Royal Children's Hospital, Brisbane

Brisbane, Queensland, Australia

Site Status

Mater Children's Hospital

Brisbane, Queensland, Australia

Site Status

Children's Youth and Women's Health Service

North Adelaide, South Australia, Australia

Site Status

Royal Children's Hospital Melbourne

Parkville, Victoria, Australia

Site Status

Princess Margaret Hospital for Children

Subiaco, Perth, Western Australia, Australia

Site Status

Stollery Children's Hospital

Edmonton, Alberta, Canada

Site Status

British Columbia Children's Hospital

Vancouver, British Columbia, Canada

Site Status

Starship Children's Hospital

Auckland, , New Zealand

Site Status

University of Cape Town

Rondebosch, Cape Town, South Africa

Site Status

Institute of Child Health, Univ. College London & Great Ormond

Bloomsbury, London, United Kingdom

Site Status

Birmingham Children's Hospital

Birmingham, West Midlands, United Kingdom

Site Status

Countries

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United States Australia Canada New Zealand South Africa United Kingdom

References

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Meinert E, Bell MJ, Buttram S, Kochanek PM, Balasubramani GK, Wisniewski SR, Adelson PD; Pediatric Traumatic Brain Injury Consortium: Hypothermia Investigators. Initiating Nutritional Support Before 72 Hours Is Associated With Favorable Outcome After Severe Traumatic Brain Injury in Children: A Secondary Analysis of a Randomized, Controlled Trial of Therapeutic Hypothermia. Pediatr Crit Care Med. 2018 Apr;19(4):345-352. doi: 10.1097/PCC.0000000000001471.

Reference Type DERIVED
PMID: 29370008 (View on PubMed)

Adelson PD, Wisniewski SR, Beca J, Brown SD, Bell M, Muizelaar JP, Okada P, Beers SR, Balasubramani GK, Hirtz D; Paediatric Traumatic Brain Injury Consortium. Comparison of hypothermia and normothermia after severe traumatic brain injury in children (Cool Kids): a phase 3, randomised controlled trial. Lancet Neurol. 2013 Jun;12(6):546-53. doi: 10.1016/S1474-4422(13)70077-2. Epub 2013 May 8.

Reference Type DERIVED
PMID: 23664370 (View on PubMed)

Other Identifiers

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1R01NS052478-01

Identifier Type: -

Identifier Source: secondary_id

1R01-NS052478-01

Identifier Type: -

Identifier Source: org_study_id