Impact of Fever Prevention in Brain Injured Patients

NCT ID: NCT02996266

Last Updated: 2023-09-21

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

686 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-01-31

Study Completion Date

2022-05-12

Brief Summary

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This study will assess the impact of fever prevention on fever burden and short- and long-term neurologic outcomes in brain injured patients. Half of the subjects will undergo fever prevention using a targeted temperature management system and half of the subjects will be treated for fever should it develop.

Detailed Description

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Multiple studies demonstrate that fever / elevated temperature is associated with poor outcomes in brain injured patients; however, there are no conclusive studies that demonstrate that fever prevention/controlled normothermia is associated with better outcomes. This study will be conducted to assess the impact of advanced temperature control to prevent fever in brain injured patients. The fever prevention group will use the Arctic Sun Temperature Management System and will be compared to standard care patients in whom fever may spontaneously develop. If fever develops in a patient in the standard care group, they will be treated with standard fever care measures according to a step-wise algorithm, consisting primarily of intermittent antipyretics (e.g., acetaminophen) and cooling blankets and, when necessary, advanced targeted temperature management devices.

Conditions

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Fever Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage

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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Fever Prevention

Fever will be prevented using a surface targeted temperature management system

Group Type EXPERIMENTAL

Targeted Temperature Management

Intervention Type DEVICE

Prophylactic normothermia

Standard Care

Standard care in which fever may spontaneously develop

Group Type ACTIVE_COMPARATOR

Standard Care

Intervention Type OTHER

No intervention to control temperature unless fever occurs

Interventions

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Targeted Temperature Management

Prophylactic normothermia

Intervention Type DEVICE

Standard Care

No intervention to control temperature unless fever occurs

Intervention Type OTHER

Other Intervention Names

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Arctic Sun 5000 Temperature Management System

Eligibility Criteria

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Inclusion Criteria

1. Admitted with a primary neurological diagnosis of ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage
2. Prior to onset of acute symptoms, was considered functionally independent (mRS 0-2)
3. Meets disease-specific criteria

Exclusion Criteria

1. Fever (≥38°C) prior to study enrollment
2. Pre-existing neurological, psychiatric, or other condition that would confound neurological assessment or would make it difficult to accurately assess neurologic and/or functional outcome
3. Has a pre-morbid condition with poor likelihood of survival to 6 months
4. Has a pre-morbid mRS ≥3
5. Diagnosed with brain death
6. Is undergoing therapeutic hypothermia therapy
7. Has sustained neurological injury felt to be catastrophic with little chance of recovery
8. Has a skin condition in which the use of the ArcticGel Pads is contraindicated (i.e., skin that has signs of ulceration, burns, hives, or rash)
9. Has poor skin integrity or poor tissue perfusion
10. Participation in a concurrent investigational / interventional study (medical device or drug)
Minimum Eligible Age

21 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yale University

OTHER

Sponsor Role collaborator

Boston University

OTHER

Sponsor Role collaborator

C. R. Bard

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David M. Greer, MD, MA

Role: PRINCIPAL_INVESTIGATOR

Boston University

Kevin N. Sheth, MD

Role: PRINCIPAL_INVESTIGATOR

Yale University

Locations

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University of Southern California

Los Angeles, California, United States

Site Status

Stanford University Hospital

Palo Alto, California, United States

Site Status

University of Colorado Hospital

Aurora, Colorado, United States

Site Status

Swedish Medical Center

Englewood, Colorado, United States

Site Status

Yale New Haven Hospital

New Haven, Connecticut, United States

Site Status

University of Florida

Gainesville, Florida, United States

Site Status

Rush University

Chicago, Illinois, United States

Site Status

Norton Neuroscience Institute

Louisville, Kentucky, United States

Site Status

Tulane Medical Center

New Orleans, Louisiana, United States

Site Status

University of Maryland Medical Center

Baltimore, Maryland, United States

Site Status

Boston University Medical Center

Boston, Massachusetts, United States

Site Status

University of Massachusetts Worcester

Worcester, Massachusetts, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

Spectrum Health Hospitals

Grand Rapids, Michigan, United States

Site Status

Washington University

St Louis, Missouri, United States

Site Status

The University of New Mexico Health Science Center

Albuquerque, New Mexico, United States

Site Status

Mount Sinai Hospital

New York, New York, United States

Site Status

Columbia University, New York - Presbyterian Hospital

New York, New York, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Wake Forest University Health Sciences

Winston-Salem, North Carolina, United States

Site Status

Ohio State University Wexner Medical Center

Columbus, Ohio, United States

Site Status

Riverside Methodist Hospital

Columbus, Ohio, United States

Site Status

Providence St Vincent Medical Center

Portland, Oregon, United States

Site Status

Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status

Rhode Island Hospital

Providence, Rhode Island, United States

Site Status

Erlanger Health System Baroness Hospital

Chattanooga, Tennessee, United States

Site Status

The University of Texas Health Science Center at Houston

Houston, Texas, United States

Site Status

Harborview Medical Center

Seattle, Washington, United States

Site Status

Royal North Shore Hospital

Sydney, New South Wales, Australia

Site Status

Royal Adelaide Hospital

Adelaide, South Australia, Australia

Site Status

Medizinische Universität Innsbruck

Innsbruck, , Austria

Site Status

Charité - Universitätsmedizin Berlin

Berlin, , Germany

Site Status

Technische Universitat Dresden

Dresden, , Germany

Site Status

Universitätsklinikum Jena

Jena, , Germany

Site Status

LMU München, Klinikum Großhadern

Munich, , Germany

Site Status

Keimyung University Dongsan Hospital

Daegu, , South Korea

Site Status

Asan Medical Center

Seoul, , South Korea

Site Status

Seoul National University Bundang Hospital

Seoul, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Universitätsspital Zürich

Zurich, , Switzerland

Site Status

Countries

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United States Australia Austria Germany South Korea Switzerland

References

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Greer DM, Helbok R, Badjatia N, Ko SB, Guanci MM, Sheth KN; INTREPID Study Group. Fever Prevention in Patients With Acute Vascular Brain Injury: The INTREPID Randomized Clinical Trial. JAMA. 2024 Nov 12;332(18):1525-1534. doi: 10.1001/jama.2024.14745.

Reference Type DERIVED
PMID: 39320879 (View on PubMed)

Greer DM, Ritter J, Helbok R, Badjatia N, Ko SB, Guanci M, Sheth KN. Impact of Fever Prevention in Brain-Injured Patients (INTREPID): Study Protocol for a Randomized Controlled Trial. Neurocrit Care. 2021 Oct;35(2):577-589. doi: 10.1007/s12028-021-01208-1. Epub 2021 Mar 24.

Reference Type DERIVED
PMID: 33761119 (View on PubMed)

Cronberg T, Greer DM, Lilja G, Moulaert V, Swindell P, Rossetti AO. Brain injury after cardiac arrest: from prognostication of comatose patients to rehabilitation. Lancet Neurol. 2020 Jul;19(7):611-622. doi: 10.1016/S1474-4422(20)30117-4.

Reference Type DERIVED
PMID: 32562686 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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BMD-1111

Identifier Type: -

Identifier Source: org_study_id

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