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CompletedNCT00987922Updated Sep 20, 2011

Mild Hypothermia in Acute Ischemic Stroke

A Phase 2 interventional study of Hypothermia in Brain Ischemia, sponsored by University of Helsinki. Completed. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2011-09-20.

Sponsored by University of Helsinki · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
36
Allocation
Randomized
Ages
18 Years to 85 Years
Sex
All
01

Study summary

Hypothesis: Mild hypothermia using non-invasive temperature management system in a stroke unit is safe and feasible in spontaneously breathing, alteplase-thrombolyzed patients with acute ischemic stroke.

Read the detailed description

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.

02

Conditions studied

  • Brain Ischemia

Keywords

  • Stroke
  • Acute
  • Infarction
  • Ischemic
  • Thrombolysis
  • Mild
  • Hypothermia
03

In context

Ischemic Stroke

2,593 studies on the registry are indexed under Ischemic Stroke; 930 are open to participants now.

This study's enrollment of 36 is below the median of 120 across 1,752 interventional studies indexed under Ischemic Stroke.

Browse Ischemic Stroke studies →

Lead sponsor

University of Helsinki is the lead sponsor of 129 studies on the registry; 19 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

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

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)
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
36 participants (actual)

Study arms

  • Experimental
    Hypothermia

    Device: Hypothermia

  • No intervention
    Control

Interventions

  • DeviceHypothermia

    Hypothermia to core temperature of 35C for 12 hours, rewarming rate 0.2C until the patient reaches 36.8C

06

What researchers measure

Primary outcomes

  1. The proportion of patients maintaining temperature below 36.0°C 80% of the 12-hour hypothermia period.

    Time frame: 12 hours

Secondary outcomes

  1. The incidence of intracerebral hemorrhage, infections, hemodynamically significant cardiac arrhythmias, severe disturbance of electrolytes and fluid balance, thrombocytopenia, and serious adverse events

    Time frame: 14 days

  2. 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.

    Time frame: 3 months

  3. The proportion of modified Rankin Scale-responders (mRS 0-2), Barthel Index, NIHSS, Glasgow Outcome Scale

    Time frame: 3 months

  4. Neuropsychological tests

    Time frame: 3 months

  5. 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)

    Time frame: 3-7 days

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Piironen K, Tiainen M, Mustanoja S, Kaukonen KM, Meretoja A, Tatlisumak T, Kaste M. Mild hypothermia after intravenous thrombolysis in patients with acute stroke: a randomized controlled trial. Stroke. 2014 Feb;45(2):486-91. doi: 10.1161/STROKEAHA.113.003180. Epub 2014 Jan 16. PubMed 24436240 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 20, 2011, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00987922
Lead sponsor
University of Helsinki
Responsible party
Katja Piironen (MD, University of Helsinki) — Principal investigator
First posted
Oct 1, 2009
Start date
Jul 2007
Primary completion
Sep 2011
Completion
Sep 2011
Last update
Sep 20, 2011

Study contacts

Markku Kaste, MD, PhD
principal investigator · Helsinki University Central Hospital

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2011. You cannot join it, but the record below documents what was studied.

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