Treating Spinal Cord Injury With Early Normobaric Hyperoxia (SpiCoH)
Treating Spinal Cord Injury With Early Normobaric Hyperoxia - A Phase IIa Feasibility Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Andrew Kline
- Phone Number: 352-273-9000
- Email: andrew.kline@neurosurgery.ufl.edu
Study Contact Backup
- Name: Ralisa Pop
- Phone Number: (352) 294-5693
- Email: Ralisa.Pop@neurology.ufl.edu
Study Locations
-
-
Florida
-
Gainesville, Florida, United States, 32610
- Recruiting
- University of Florida
-
Contact:
- Andrew Kline
- Phone Number: 724-496-8034
- Email: andrew.kline@ufl.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Provision of signed and dated ICF by the subject or LAR
- Stated willingness to comply with all study procedures for the duration of the study
- Male or female subjects, aged ≥18 and ≤ 85 years
- Admitted with a diagnosis of blunt or penetrating traumatic cervical and/or thoracic SCI (maintaining dural sac integrity)
- Awake and able to interact and follow commands
- American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades A, B or C
- Need for mechanical ventilation (MV), as determined by the treating physician
- Baseline PaO2 >80 mmHg before enrollment
- Capacity to initiate the study intervention within 24 hours of injury
Exclusion Criteria:
- Evidence of traumatic brain injury by neuroimaging (either CT or MRI) including, but not limited to, traumatic subarachnoid hemorrhage, subdural hematoma, epidural hematoma, intracranial hemorrhage, parenchymal contusions, and blunt cerebrovascular injury grades II-V
- AIS grades D or E at time of arrival to hospital
- Persistent hypoxia requiring >40% FiO2 to maintain PaO2 >80 mmHg
- Concurrent injuries contraindicating lumbar drain placement, including, but not limited to: signs of infection at insertion site, elevated intracranial pressure, supratentorial mass lesion with mass effect, posterior fossa mass or uncorrected coagulopathy (thrombocytopenia <100,000/μL or International Normalized Ratio >1.5)
- Pre-existing neurologic conditions that would confound neurologic assessment or would make difficult to accurately assess neurologic and/or functional outcomes
- Pre-existing respiratory or pulmonary conditions that would impact ventilation mechanics or confound the assessment of respiratory recovery
- Participation in a concurrent investigational/interventional study (observational studies allowed)
- Known to be pregnant, or with a positive pregnancy test
- Vulnerable populations such as prisoners and inmates (abiding GCP per the study IRB)
- Patient has any other clinically significant medical condition as determined by the investigator, that may unfavorably alter the risk-benefit of study participation, adversely affect study compliance, or confound interpretation of study results
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention
Normobaric hyperoxia
|
Intermittent normobaric hyperoxia (NBH) by increasing FiO2 to 100% for a duration of 4.5h (270 min), twice daily over five consecutive days.
Instead of fixed 12-hour intervals between sessions, the two daily treatments will follow a pre-specified interval: a minimum of 1.5h (90min) between sessions for treatment B, and 10h (600min) for treatment A.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Feasibility of early normobaric hyperoxic therapy
Time Frame: 24 hours from injury
|
Proportion of subjects receiving first normobaric hyperoxia therapy.
|
24 hours from injury
|
|
Preliminary efficacy of intermittent normobaric hyperoxia in achieving high oxygen concentrations systemically
Time Frame: From enrollment to the end of intervention period at 5 days
|
Serial PaO2
|
From enrollment to the end of intervention period at 5 days
|
|
Preliminary safety of intermittent normobaric hyperoxia
Time Frame: From completion of first treatment to end of 6 month follow up period
|
Four-point end-organ toxicity surveillance.
|
From completion of first treatment to end of 6 month follow up period
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Feasibility of intermittent therapeutic hyperoxemia and elevated oxygen concentration
Time Frame: From enrollment to the end of intervention period at 5 days
|
Serial PaO2.
Proportion of subjects receiving all 10 planned normobaric hyperoxia treatments.
|
From enrollment to the end of intervention period at 5 days
|
|
Exploratory safety objectives
Time Frame: From enrollment to end of 6 month follow up period
|
Rates of study termination from demonstrated signs of organ injury attributable to hyperoxia determined by safety monitoring board
|
From enrollment to end of 6 month follow up period
|
|
Feasibility - Timely Placement of Lumbar Drain
Time Frame: Time of injury to 24hr post injury.
|
Proportion of subjects with lumbar drain placed before initiation of normobaric hyperoxia.
|
Time of injury to 24hr post injury.
|
|
Feasibility - Completion of Required Monitoring Lines
Time Frame: Day 0 to day 5
|
Proportion of subjects with lumbar drain and arterial line for the duration of 5-day intervention period.
|
Day 0 to day 5
|
|
Protocol Adherence - Sampling Deviations
Time Frame: Enrollment to end of 6 month follow up period
|
Rate of protocol violations or deviations related to missing samples or samples obtained outside the planned schedule for blood and/or CSF.
|
Enrollment to end of 6 month follow up period
|
|
Sample Handling - Discarded Specimens
Time Frame: From enrollment to end of 6 month follow up period
|
Rate of discarded CSF or blood samples
|
From enrollment to end of 6 month follow up period
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Carolina Maciel, MD, MSCR, University of Florida
- Principal Investigator: Katharina Busl, MD, MS, University of Florida
- Principal Investigator: Daryl Fields, MD, PhD, University of Florida
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
- IRB202400873
- 4R00GM159353-02 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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