Time-differentiated Therapeutic Hypothermia (TTH48)
Time-differentiated Treatment With Mild Therapeutic Hypothermia Following Cardiac Arrest, a Multi Center Study.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Brussels, Belgium, 1070
- Department of Intensive Care, Erasme Hospital
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Aalborg, Denmark, 9000
- Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aalborg
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Aarhus, Denmark, 8200
- Department og Anesthesiologi and Intensive Care Medicine,
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Copenhagen, Denmark, 2100
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet
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Odense, Denmark, 5000
- Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital
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Tallinn, Estonia, 13419
- Anaesthesiology Clinic, North Estonia Medical Centre
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Helsinki, Finland, 00029-HUS
- Division of Anaesthesiology and Intensive Care Medicine, Department of Surgery, Helsinki University Central Hospital
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Turku, Finland
- Hospital District of Southwest Finland), Kiinamyllynkatu
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Berlin, Germany
- Department of Internal Medicine, Nephrology and Intensive Care; Charité-Universitätsmedizin Berlin
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Stavanger, Norway, 4068
- Anesthesiology and Critical Care, Stavanger University Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Out of hospital cardiac arrest of suspected cardiac origin
- Return of spontaneous circulation (ROSC)
- Glasgow Coma Score < 8
- Estimated time interval from cardiac arrest to ROSC ≤ 60 min
Exclusion Criteria:
- OOH-CA of suspected origin other than cardiac
- In hospital Cardiac arrest
- Terminal disease
- Coagulation disorders
- Unwitnessed asystolia
- Time from cardiac arrest to start of hypothermia treatment > 240 min
- GCS ≥ 8
- Pregnancy
- Persistent cardiogenic shock (Systolic blood pressure < 80 mmHg despite inotropic treatment and aortic balloon pump).
- CPC 3-4 before cardiac arrest
- Acute intra cerebral bleeding
- Acute stroke
- Acute coronary artery bypass grafting
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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ACTIVE_COMPARATOR: 24 hours hypothermia
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Mild therapeutic hypothermia with a target temperature of 33 degrees Centigrade for 24 or 48 hours
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EXPERIMENTAL: 48 hours hypothermoa
48 hours hypothermia
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Mild therapeutic hypothermia with a target temperature of 33 degrees Centigrade for 24 or 48 hours
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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CPC
Time Frame: 6 month
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CPC = Cerebral Performance Category Score.
The primary outcome of the study is analyzed as the proportion of patients with good neurological outcome in the two groups, (CPC 1-2) at 6 months after CA.
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6 month
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Adverse events
Time Frame: 10 days
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Adverse events are registered during the treatment and until discharge from primary hospital unit
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10 days
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CPC at discharge
Time Frame: 3 month
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CPC at discharge from primary hospital unit and after 28 days plus after 3 month
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3 month
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Mortality
Time Frame: 6 month
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CPC 5 at 6 month
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6 month
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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GCS
Time Frame: 28 days
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Glasgow Coma Score at day 4 and at discharge from primary hospital unit
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28 days
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GCS progression
Time Frame: 25 weeks
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Glasgow Coma Score throughout the observation period
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25 weeks
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Hans Kirkegaard, Professor, Department of Anaesthesia and Intensive care medicine, Aarhus University Hosptal, Brendstrupgaardsvej 8200 Aarhus, Denmark
Publications and helpful links
General Publications
- Larsen AI, Grejs AM, Vistisen ST, Strand K, Skadberg O, Jeppesen AN, Duez CHV, Kirkegaard H, Soreide E. Kinetics of 2 different high-sensitive troponins during targeted temperature management in out-of-hospital cardiac arrest patients with acute myocardial infarction: a post hoc sub-study of a randomised clinical trial. BMC Cardiovasc Disord. 2022 Jul 30;22(1):342. doi: 10.1186/s12872-022-02778-4.
- Bach HM, Duez CHV, Jeppesen AN, Strand K, Soreide E, Kirkegaard H, Grejs AM. MR-proANP and NT-proBNP During Targeted Temperature Management Following Out-of-Hospital Cardiac Arrest: A Post hoc Analysis of the TTH48 Trial. Ther Hypothermia Temp Manag. 2022 Jun;12(2):82-89. doi: 10.1089/ther.2021.0012. Epub 2021 Aug 10.
- Hastbacka J, Kirkegaard H, Soreide E, Taccone FS, Rasmussen BS, Storm C, Kjaergaard J, Laitio T, Duez CHV, Jeppesen AN, Grejs AM, Skrifvars MB. Severe or critical hypotension during post cardiac arrest care is associated with factors available on admission - a post hoc analysis of the TTH48 trial. J Crit Care. 2021 Feb;61:186-190. doi: 10.1016/j.jcrc.2020.10.026. Epub 2020 Nov 2.
- Skrifvars MB, Soreide E, Sawyer KN, Taccone FS, Toome V, Storm C, Jeppesen A, Grejs A, Duez CHV, Tiainen M, Rasmussen BS, Laitio T, Hassager C, Kirkegaard H. Hypothermic to ischemic ratio and mortality in post-cardiac arrest patients. Acta Anaesthesiol Scand. 2020 Apr;64(4):546-555. doi: 10.1111/aas.13528. Epub 2019 Dec 26.
- Evald L, Bronnick K, Duez CHV, Grejs AM, Jeppesen AN, Soreide E, Kirkegaard H, Nielsen JF. Prolonged targeted temperature management reduces memory retrieval deficits six months post-cardiac arrest: A randomised controlled trial. Resuscitation. 2019 Jan;134:1-9. doi: 10.1016/j.resuscitation.2018.12.002. Epub 2018 Dec 17.
- Kirkegaard H, Soreide E, de Haas I, Pettila V, Taccone FS, Arus U, Storm C, Hassager C, Nielsen JF, Sorensen CA, Ilkjaer S, Jeppesen AN, Grejs AM, Duez CHV, Hjort J, Larsen AI, Toome V, Tiainen M, Hastbacka J, Laitio T, Skrifvars MB. Targeted Temperature Management for 48 vs 24 Hours and Neurologic Outcome After Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2017 Jul 25;318(4):341-350. doi: 10.1001/jama.2017.8978.
- Kirkegaard H, Pedersen AR, Pettila V, Hjort J, Rasmussen BS, de Haas I, Nielsen JF, Ilkjaer S, Kaltoft A, Jeppesen AN, Grejs AM, Duez CH, Larsen AI, Toome V, Arus U, Taccone FS, Storm C, Laitio T, Skrifvars MB, Soreide E. A statistical analysis protocol for the time-differentiated target temperature management after out-of-hospital cardiac arrest (TTH48) clinical trial. Scand J Trauma Resusc Emerg Med. 2016 Nov 28;24(1):138. doi: 10.1186/s13049-016-0334-0.
- Kirkegaard H, Rasmussen BS, de Haas I, Nielsen JF, Ilkjaer S, Kaltoft A, Jeppesen AN, Grejs A, Duez CH, Larsen AI, Pettila V, Toome V, Arus U, Taccone FS, Storm C, Skrifvars MB, Soreide E. Time-differentiated target temperature management after out-of-hospital cardiac arrest: a multicentre, randomised, parallel-group, assessor-blinded clinical trial (the TTH48 trial): study protocol for a randomised controlled trial. Trials. 2016 May 4;17(1):228. doi: 10.1186/s13063-016-1338-9.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- TTH48
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