Hypothermia Clinical Trial
Official title:
A Comparison of Forced-air With Endovascular Warming for Treatment of Accidental Hypothermia in Polytrauma Victims
Trauma is the leading cause of death in young adults, bleeding and infection are major concomitant problems. We test the hypothesis that fast, perioperative warming with an endovascular catheter versus forced air warming may improve patient outcome (primary outcome: combined perioperative morbidity, secondary outcome: bleeding, infection).
Trauma is the leading cause of death in young adults and a major cause of morbidity and
mortality at all ages. The acute problem is often uncontrollable bleeding. Subsequently,
infection becomes a leading cause of morbidity. Polytrauma patients are at high risk for
accidental hypothermia. Mild perioperative hypothermia causes a coagulopathy that
significantly augments blood loss and increases allogeneic transfusion requirements.
Hypothermia also impairs numerous immune functions - even slight decreases in core
temperature triple the risk of surgical wound infection.
Endovascular temperature management system Alsius® (ICY, Alsius Corporation:
Irvine,California,USA) has been approved in Europe and United States for the past 10 years
and has been used in thousands of patients mainly for the indication of therapeutic cooling
and subsequently rewarming of patients. A major potential advantage of this system is that
heat is directly added to the thermal core, thus bypassing the heat sink and insulating
effects of peripheral tissues. The efficacy of this system is sufficient to allow rapid
rewarming in hypothermic trauma victims, even those undergoing major surgery. We therefore
propose to test the hypothesis that polytrauma patients rewarmed with the Alsius® system
will have better patient outcome (combined perioperative morbidity) than those warmed
conventionally with forced-air.
;
Allocation: Randomized, Intervention Model: Factorial Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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