Burns Clinical Trial
Official title:
Thermogard™ Efficacy Trial
The purpose of this study is to determine if the Thermogard™ central venous catheter can prevent hypothermia (defined as a core body temperature less then 36.0 °C) in severely burned patients who are undergoing surgery for debridement and grafting in the setting of reduced ambient room temperature.
Hypothermia in the severely burned has been shown to disrupt coagulation, impair myocardial
function, weaken the host immune response, delay wound healing and increase mortality.
Current methods available for preventing and reversing hypothermia include administering
heated, humidified oxygen, infusing warmed intravenous fluids centrally, performing
peritoneal dialysis with warmed fluid, undergoing extracorporeal blood warming with partial
bypass, and markedly increasing the ambient room temperature. These methods are either
limited in their effectiveness or are impractical and potentially dangerous. Furthermore,
the practice of markedly increasing the ambient room temperature creates a hostile work
environment for health care providers which may impact patient care.
The FDA has classified the Alsius Thermogard™ heat exchange catheter as a Class II devices
under 21 C.F.R §§ 870.5900. It is used in various clinical applications for cooling patients
but it has not been FDA-approved for use in warming burn patients. The Thermogard™ is an
integrated electro-mechanical heater/cooler that consists of a temperature monitor, a
temperature controller unit, a heat exchanger unit, and roller pump. It supplies temperature
controlled sterile saline to the indwelling catheter that is placed percutaneously in the
patient. The catheter can be placed in the femoral vein (larger catheter with three heat
exchange balloons) or the subclavian or jugular vein (smaller catheter with two heat
exchange balloons).
Sterile saline is warmed (to a maximum temperature of 38 °C) in the external device and then
pumped through the balloons coaxially mounted on the catheter, enabling direct warming of
the blood. The catheter contains a temperature probe enabling a 'closed loop' temperature
control system; the temperature is set at the desired level (the range of the device is
28-38°C, which may vary according to the installed software), after which the device warms
the patient to this level by increasing or decreasing the temperature of the circulating
saline. The core temperature is then maintained at the desired level for as long as the
attending physician deems necessary. The catheter also has two ports for central venous
access, which can be used to administer medication and/or for blood sampling.
The purpose of this study is to determine if the Thermogard™ central venous catheter can
significantly impact the heat stress environment of the operating room by allowing severely
burned patients to undergo surgery for debridement and grafting at lower ambient operating
room temperatures when compared to control subjects.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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