- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT00222742
Hypothermia in Children After Trauma
Pediatric Traumatic Brain Injury Consortium: Hypothermia
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
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).
Tipo de estudio
Inscripción (Actual)
Fase
- Fase 3
Contactos y Ubicaciones
Ubicaciones de estudio
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New South Wales
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Sydney, New South Wales, Australia, 2031
- Sydney Children's Hospital, Randwick
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Westmead, New South Wales, Australia, 2145
- Children's Hospital at Westmead
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Queensland
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Brisbane, Queensland, Australia, 4029
- Royal Children's Hospital, Brisbane
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Brisbane, Queensland, Australia, 4101
- Mater Children's Hospital
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South Australia
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North Adelaide, South Australia, Australia, 5006
- Children's Youth and Women's Health Service
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Victoria
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Parkville, Victoria, Australia, 3052
- Royal Children's Hospital Melbourne
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Western Australia
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Subiaco, Perth, Western Australia, Australia, 6008
- Princess Margaret Hospital for Children
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Alberta
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Edmonton, Alberta, Canadá, T6G2B7
- Stollery Children's Hospital
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British Columbia
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Vancouver, British Columbia, Canadá, V4A 5X3
- British Columbia Children's Hospital
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Arizona
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Phoenix, Arizona, Estados Unidos, 85016
- Phoenix Childrens Hospital
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California
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Sacramento, California, Estados Unidos, 95817
- University of California, Davis Medical Center
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District of Columbia
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Washington, District of Columbia, Estados Unidos, 20010
- Children's National Medical Center
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Florida
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Miami, Florida, Estados Unidos, 33136
- University of Miami
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Minnesota
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Rochester, Minnesota, Estados Unidos, 55905
- Mayo Clinic in Rochester
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Missouri
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St. Louis, Missouri, Estados Unidos, 63110
- Washington University
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New York
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New Hyde Park, New York, Estados Unidos, 11040
- Cohen's Children's Hospital
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New York, New York, Estados Unidos, 10950
- Weill Cornell Medical Center
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North Carolina
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Charlotte, North Carolina, Estados Unidos, 28203
- Carolinas Medical Center
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Durham, North Carolina, Estados Unidos, 27710
- Duke University
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Ohio
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Cincinnati, Ohio, Estados Unidos, 47229-3039
- Cincinnati Children's Hospital Medical Center
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Columbus, Ohio, Estados Unidos, 43205
- Nationwide Children's Hospital
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Pennsylvania
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Hershey, Pennsylvania, Estados Unidos, 17033
- Penn State Hershey Medical Center
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Philadelphia, Pennsylvania, Estados Unidos, 19104
- Children's Hospital of Philadelphia
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Pittsburgh, Pennsylvania, Estados Unidos, 15213
- University of Pittsburgh/Children's Hospital of Pittsburgh
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Texas
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Dallas, Texas, Estados Unidos, 75235
- University of Texas, Southwestern
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Washington
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Seattle, Washington, Estados Unidos, 98104
- University of Washington
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Auckland, Nueva Zelanda, 1023
- Starship Children's Hospital
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London
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Bloomsbury, London, Reino Unido, WC1N 3JH
- Institute of Child Health, Univ. College London & Great Ormond
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West Midlands
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Birmingham, West Midlands, Reino Unido, UK B4 6NH
- Birmingham Children's Hospital
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Cape Town
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Rondebosch, Cape Town, Sudáfrica, 7700
- University of Cape Town
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Patients with a GCS </= 8
- Glasgow Motor Score < 6
- Closed head injury
- Age 0 < 18 y
Exclusion Criteria
- Unavailable to initiate cooling within 6 hours of injury
- Glasgow Coma Scale (GCS) score = 3 and abnormal brainstem function
- Normal initial CT scan (No blood, fracture, swelling, and/or shift)
- Penetrating brain injury
- No known mechanism of injury
- Unknown time of injury
- Uncorrectable coagulopathy (PT/PTT > 16/40 sec, INR > 1.7)
- Hypotensive episode (Systolic Blood Pressure <5th percentile for age>10 min)
- Documented Hypoxic episode (O2 saturation < 94% for > 30 min)
- Pregnancy
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Experimental: A
Induced moderate hypothermia (32-33 C)
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Subjects assigned to the treatment arm will be cooled to 32-33 °C for 48 hours and then slowly warmed.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
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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.
Periodo de tiempo: 3 month post injury
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3 month post injury
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Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
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To determine the effect of HYPO after severe TBI in children on global function and neurocognitive outcomes in the areas of intellectual ability/development, memory and learning, and behavior.
Periodo de tiempo: at 6 and 12 months post injury
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at 6 and 12 months post injury
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To determine the effect of HYPO after severe TBI in children of different age ranges (< 6y; 6-<16y; and 16-<18y) on mortality and 6 and 12 months functional and neurocognitive outcomes.
Periodo de tiempo: 3, 6 and 12 months post injury
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3, 6 and 12 months post injury
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To determine the effect of HYPO after severe TBI in children on reducing intracranial hypertension and maintaining adequate cerebral perfusion pressure (CPP).
Periodo de tiempo: 7 days post injury
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7 days post injury
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: P. David Adelson, MD, Phoenix Children'S Hospital
Publicaciones y enlaces útiles
Publicaciones Generales
- 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.
- 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.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 1R01-NS052478-01
- 1R01NS052478-01
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