Safty and Feasibility Study of Therapeutic Cooling in Acute Ischemic Stroke (COOLAID Øresund)

NCT ID: NCT01500421

Last Updated: 2011-12-28

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

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

31 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-10-31

Study Completion Date

2011-11-30

Brief Summary

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This study is designed to investigate the safty and feasibility of therapeutic hypothermia in acute stroke patients. Soon after arrival in the stroke unit patients are randomized to either hypothermia in the intensive care unit (ICU) or standard treatment in the stroke ward.

Patients randomized to therapeutic hypothermia are analgo-sedated and cooled to at temperature of 33 degrees for a period of 24 hours.

Detailed Description

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Ischemic stroke remains a diagnosis with limited treatment opportunities and a treatment with the ability to target patients outside the normal treatment window is wanted.

Therapeutic hypothermia (TH) treatment has long been recognised as a treatment of patients with global ischemia following caridac arrest.

This trial is designed to address the safty and feasibility of TH in acute stroke patients.

Patients arriving in our stroke ward are observed for 3 hours. Only non-remitting patients are allowed into the trial.

Patients are randomized to either therapeutic hypothermia with endovascular catheter + nasopharyngeal induction or endovascular catheter alone in the intensive care unit (ICU) (in Copenhagen, Denmark) or intravenous cold saline infusion followed by surface cooling (in Malmø, Sweden)versus standard treatment in a stoke unit.

Patients brought to the ICU are sedated and mechanically ventilated.

Therapeutic hypothermia is induced with a endovascular catether and a nasopharyngeal catheter. Body temperature is lowered to 33 degrees and sustained for a period of 24 hours.

Conditions

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Cerebral Infarction

Keywords

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Hypothermia, Induced

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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TH - Endovacular alone

Patients randomized to this arm are cooled to a bodytemperature of 33 degrees with an endovascular groin catheter (Copenhagen only).

Group Type EXPERIMENTAL

TH - Endovascular alone (Alsius®, Zoll, USA)

Intervention Type DEVICE

Patients are cooled with an endovascular (Alsius®, Zoll, USA) groin catether (9,3 french).

TH - Endovascular + nasopharyngeal induction

Patients randomized to this arm are cooled to a bodytemperature of 33 degrees with endovascular catheter along with nasopharyngeal induction (Copenhagen only).

Group Type EXPERIMENTAL

TH - Endovascular + nasopharyngeal induction (Alsius®, Zoll, USA) (Rhinochill®, Benechill, USA)

Intervention Type DEVICE

Patient are cooled with a groin endovascular catheter (Alsius®, Zoll, USA) + a nasopharyngeal induction catheter (Rhinochill®, Benechill, USA) in the nostrils. The nasopharyngeal induction is designed to give a more quick and localised brain cooling.

Standard Treatment

Patients are treated with standard care in the stroke ward.

Group Type NO_INTERVENTION

No interventions assigned to this group

TH - Surface Cooling

Patients randomized to this arm are cooled to a bodytemperature of 33 degrees with cold saline infusion followed by surface cooling with Arctic Sun Cooling system, Medivance, USA (Malmø only)

Group Type EXPERIMENTAL

Intravenous cold saline and surface cooling (Arctic Sun, Medivance, USA)

Intervention Type DEVICE

Infusion of ice cold saline of 4°C (25 mL/kg body weight)followed by surface cooling

Interventions

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TH - Endovascular alone (Alsius®, Zoll, USA)

Patients are cooled with an endovascular (Alsius®, Zoll, USA) groin catether (9,3 french).

Intervention Type DEVICE

TH - Endovascular + nasopharyngeal induction (Alsius®, Zoll, USA) (Rhinochill®, Benechill, USA)

Patient are cooled with a groin endovascular catheter (Alsius®, Zoll, USA) + a nasopharyngeal induction catheter (Rhinochill®, Benechill, USA) in the nostrils. The nasopharyngeal induction is designed to give a more quick and localised brain cooling.

Intervention Type DEVICE

Intravenous cold saline and surface cooling (Arctic Sun, Medivance, USA)

Infusion of ice cold saline of 4°C (25 mL/kg body weight)followed by surface cooling

Intervention Type DEVICE

Other Intervention Names

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Arctic Sun, Medivance, USA

Eligibility Criteria

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Inclusion Criteria

* National Institute of Health Stroke Scale (NIHSS) score on admission between 5 and 18
* Inclusion within 24 hours after stroke onset
* Diagnosis of ischemic stroke verified by MRI, CT or CTP adjudicated by including physician
* Informed consent from patient or proxy

Exclusion Criteria

* Modified ranking scale (mRS)\>2 indicating significant disability before onset of stroke
* MRI or CT evidence for massive ischemic damage (\>50% Middle cerebral artery (MCA) territory)
* Severe concomitant diseases such as heart failure, chronic obstructive lung disease or known cancer
* Presently on anticoagulation treatment
* No informed consent from patient or proxy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Malmö University

OTHER

Sponsor Role collaborator

Bispebjerg Hospital

OTHER

Sponsor Role lead

Responsible Party

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Derk W. Krieger MD, Ph.D

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Bispebjerg Hospital

Copenhagen, Capital Region, Denmark

Site Status

Countries

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Denmark

References

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De Georgia MA, Krieger DW, Abou-Chebl A, Devlin TG, Jauss M, Davis SM, Koroshetz WJ, Rordorf G, Warach S. Cooling for Acute Ischemic Brain Damage (COOL AID): a feasibility trial of endovascular cooling. Neurology. 2004 Jul 27;63(2):312-7. doi: 10.1212/01.wnl.0000129840.66938.75.

Reference Type BACKGROUND
PMID: 15277626 (View on PubMed)

Hamann GF, Burggraf D, Martens HK, Liebetrau M, Jager G, Wunderlich N, DeGeorgia M, Krieger DW. Mild to moderate hypothermia prevents microvascular basal lamina antigen loss in experimental focal cerebral ischemia. Stroke. 2004 Mar;35(3):764-9. doi: 10.1161/01.STR.0000116866.60794.21. Epub 2004 Feb 19.

Reference Type BACKGROUND
PMID: 14976330 (View on PubMed)

Krieger DW, De Georgia MA, Abou-Chebl A, Andrefsky JC, Sila CA, Katzan IL, Mayberg MR, Furlan AJ. Cooling for acute ischemic brain damage (cool aid): an open pilot study of induced hypothermia in acute ischemic stroke. Stroke. 2001 Aug;32(8):1847-54. doi: 10.1161/01.str.32.8.1847.

Reference Type BACKGROUND
PMID: 11486115 (View on PubMed)

Lyden PD, Allgren RL, Ng K, Akins P, Meyer B, Al-Sanani F, Lutsep H, Dobak J, Matsubara BS, Zivin J. Intravascular Cooling in the Treatment of Stroke (ICTuS): early clinical experience. J Stroke Cerebrovasc Dis. 2005 May-Jun;14(3):107-14. doi: 10.1016/j.jstrokecerebrovasdis.2005.01.001.

Reference Type BACKGROUND
PMID: 17904009 (View on PubMed)

Milhaud D, Thouvenot E, Heroum C, Escuret E. Prolonged moderate hypothermia in massive hemispheric infarction: clinical experience. J Neurosurg Anesthesiol. 2005 Jan;17(1):49-53.

Reference Type BACKGROUND
PMID: 15632543 (View on PubMed)

Schwab S, Georgiadis D, Berrouschot J, Schellinger PD, Graffagnino C, Mayer SA. Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Stroke. 2001 Sep;32(9):2033-5. doi: 10.1161/hs0901.095394.

Reference Type BACKGROUND
PMID: 11546893 (View on PubMed)

Other Identifiers

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H-D-2008-105

Identifier Type: -

Identifier Source: org_study_id