Systemic Hypothermia in Acute Cervical Spinal Cord Injury

Purpose

This study is a prospective multi-center trial designed to determine the safety profile and efficacy of modest (33ºC) intravascular hypothermia following acute cervical (C1 to C8) Spinal Cord Injury (SCI).

Condition

  • Spinal Cord Injury, Acute

Eligibility

Eligible Ages
Between 18 Years and 70 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • 18 - 70 years of age - AIS Grade A - C - Glasgow Coma Scale ≥14 - Able to start hypothermia treatment within 24 hours of injury - Non-penetrating injury. Patients urgently taken to the operating room for surgical reduction may also be included.

Exclusion Criteria

  • Age > 70 years - AIS Grade D - Hyperthermia on admission (>38.5ºC) - Severe systemic injury - Severe bleeding - Pregnancy - Coagulopathy - Thrombocytopenia - Known prior severe cardiac history - Blood dyscrasia - Pancreatitis - Reynaud's syndrome - Cord transection

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Hypothermia 		Intravascular hypothermia will be initiated within 24 hours post-injury and 33 degrees Celsius will be maintained for 48 hours.
  • Other: Hypothermia
    To deliver intravascular hypothermia, an Alsius Icy CoolGuard® catheter (US Food and Drug Administration approved, Premarket Notification [510(k), K030421]; Alsius Corporation, Irvine, California) will be inserted through the femoral vein using a sterile technique. Patients will be cooled at a maximum rate (2-2.5 ºC/hr.) until they reach the target temperature (T 33 ºC), which will be maintained for 48 hours, and then re-warmed at 0.1 ºC/hr. until normothermia (T 37ºC) is achieved.
No Intervention
Control 		Standard of care medical treatment, specific to each individual.

Recruiting Locations

University of Maryland School of Medicine
Baltimore, Maryland 21201
Contact:
Leslie Sult, BSN, RN
410-328-3657
lsult@som.umaryland.edu

More Details

Status
Recruiting
Sponsor
University of Miami

Study Contact

George Jimsheleishvili, MD
305-243-4781
gxj150@miami.edu

Detailed Description

The purpose of the proposed clinical trial is to demonstrate the safety and efficacy of intravascular hypothermia as part of the early hospital management and treatment for acute cervical SCI. Each year in the US, there are over 11,000 new cases of para- and quadriplegia and 100,000 new cases of partial but permanent neurological losses due to acute SCI. Thus the potential for clinical hypothermia following SCI to improve neurological outcome has significant value. Many patients suffering SCI become permanently dependent on caretakers and become a financial liability to both the family and society. Hypothermia has the potential to improve outcome so that more patients suffering SCI can regain independent motor and sensory function and remain economically productive members of society. The use of modest hypothermia through intravascular cooling may ultimately lead to better care of the patient with acute SCI and may also have more widespread uses in patients presenting with stroke or cardiac arrest. In the long-term, this research may lend support to the use of hypothermia that could in turn save money for the patients, hospitals, the government and society as a whole.