- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT00987922
Mild Hypothermia in Acute Ischemic Stroke
Mild Hypothermia in Acute Ischemic Stroke After Thrombolytic Therapy: a Prospective,Open,Randomized,Single-center,Safety and Feasibility Study
Studieoversikt
Detaljert beskrivelse
Fever is associated with higher stroke mortality and poor outcome, but it is yet unknown whether this association is causative or epiphenomenal.
In temporary brain ischemia rodent models hypothermia results in a significant increase in the number of surviving neurons and smaller infarction size as measured with histological examination after death.
Therapeutic effect has been shown in clinical trials in comatose cardiac arrest patients and newborn infants with perinatal hypoxic-ischemic brain injury.
Design: A prospective, open, randomized single-center study.
Study population: 36 patients, 18-85 years of age presenting with symptoms of acute ischemic hemispheric stroke with persisting significant neurological deficit (NIHSS 7-20 or NIHSS 2 for dysphasia or NIHSS 3 for paralysis of upper or lower limb) at 2 hours after thrombolysis.
Method: Patients are randomized to hypothermia- or control-group via randomization envelopes. Patients assigned to receive hypothermia are cooled to a core temperature of 35°C for 12 hours by means of a non-invasive temperature management system and cold i.v. fluids. Induction of hypothermia is initiated within 6 hours of symptom onset. After 12 hours of successful cooling the target temperature is gradually raised to achieve slow re-warming of 0.2°C/h until the core temperature reaches 36.8°C.
Patients are breathing spontaneously and shivering is controlled with following medication; dexmedetomidine 0.2-0.7 µg/kg/h (i.v.), buspirone 5-20 mg x 3 (nasogastric tube), and meperidine 25mg (i.v.) when needed.
Core temperature, blood pressure (BP), oxygen saturation, ECG and EEG are measured continuously and registered hourly. Blood tests will be taken before, during and after hypothermia. Brain CT will be controlled when normothermia is reached, no later than 30 hours from symptom onset. Brain MRI will be performed 3-7 days from symptom onset.
Studietype
Registrering (Faktiske)
Fase
- Fase 2
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Acute ischemic hemispheric stroke treated with Actilyse(tPA)-thrombolysis according to Meilahti protocol
- NIHSS 7-20 (after thrombolysis) or a significant paresis of arm or leg (NIHSS 3, no movement against gravity) or a significant dysphasia (NIHSS 2-3) despite of the total NIHSS score
- Symptom onset within 6 hour
Exclusion Criteria:
- Platelet count < 75,000/mm3
- Known coagulopathy (INR spontaneously >1.5)
- Hemodynamical unstability
- Recent history of angina pectoris or acute myocardial infarction
- Sepsis within 72 hours
- Pregnancy
- Pre-existing neurological disability with modified Rankin Scale Score>2
- Known allergy or intolerance to buspirone, dexmedetomidine, meperidine
- Intracranial hemorrhage in brain CT scan
- Intracranial mass lesion (i.e., abscess, tumor, or infection)
- Participation in an other therapy trial within last 3 months
- Hypothermia- treatment cannot be initiated within 6 hours of symptom onset
- Protocol violation in thrombolytic therapy
- Any condition where researchers assume that the patient is not suitable (must be reasoned)
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Ingen inngripen: Styre
|
|
Eksperimentell: Hypothermia
|
Hypothermia to core temperature of 35C for 12 hours, rewarming rate 0.2C until the patient reaches 36.8C
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tidsramme |
---|---|
The proportion of patients maintaining temperature below 36.0°C 80% of the 12-hour hypothermia period.
Tidsramme: 12 hours
|
12 hours
|
Sekundære resultatmål
Resultatmål |
Tidsramme |
---|---|
The incidence of intracerebral hemorrhage, infections, hemodynamically significant cardiac arrhythmias, severe disturbance of electrolytes and fluid balance, thrombocytopenia, and serious adverse events
Tidsramme: 14 days
|
14 days
|
All-cause mortality during acute phase (7 days), 1 month, and 3 month follow-up; and readmission to hospital for any reason within 3-months.
Tidsramme: 3 months
|
3 months
|
The proportion of modified Rankin Scale-responders (mRS 0-2), Barthel Index, NIHSS, Glasgow Outcome Scale
Tidsramme: 3 months
|
3 months
|
Neuropsychological tests
Tidsramme: 3 months
|
3 months
|
Size of infarction in MRI, and grading of the possible hemorrhagic transformation according to SITS scale (MRI includes scout images, DWI, T1, T2, FLAIR, T2*, and MR angiography)
Tidsramme: 3-7 days
|
3-7 days
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Hovedetterforsker: Markku Kaste, MD, PhD, Helsinki University Central Hospital
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- FI-HUCH-220424
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .
Kliniske studier på Hjerneiskemi
-
Nicholas Balderston, PhDRekruttering
-
National Institute of Neurological Disorders and...Fullført
-
University of MichiganAvsluttetEndringer i Brain Network ConnectivityForente stater
-
Assiut UniversityFullført
-
Groupe Hospitalier Paris Saint JosephFullført
-
Xijing Hospital of Digestive DiseasesRekrutteringBrain Connectivity | Forstoppelse - Funksjonell | fMRI | Behandlingseffekt | Fluoksetin | Somatisk symptom | Ildfast forstoppelse | Psykisk symptomKina
-
University of Alabama at BirminghamRekrutteringHypertensjon | BMI | Trening | Brain Care ScoreForente stater
-
University Hospital, AntwerpRekrutteringBrystrekonstruksjon | Mastektomi | Flap IschemiBelgia
-
Queen Mary University of LondonUniversity College, LondonTilbaketrukketIschemi-reperfusjon (IR) skadeStorbritannia
-
Assiut UniversityUkjent