Multicenter Study Evaluates Effectiveness of Therapeutic Hypothermia in Extending Survival and Reducing Brain Injury
NewYork-Presbyterian/Morgan Stanley Children’s Hospital Is the Only Site in the NYC Area to Offer the Clinical Trial
Nov 9, 2010
When the heart is stopped and restarted, the patient's life may be saved but the brain is often permanently damaged. Therapeutic hypothermia, a treatment in which the patient's body temperature is lowered and maintained several degrees below normal for a period of time, has been shown to mitigate these harmful effects and improve survival in adults.
Now, in the first large-scale multicenter study of its kind, physician-scientists are evaluating the effectiveness of the technique in infants and children. Offered in the greater New York metropolitan area solely by Columbia University Medical Center researchers at NewYork-Presbyterian/Morgan Stanley Children's Hospital, the Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA) trial is funded by the National Heart, Lung and Blood Institute, part of the National Institutes of Health.
"A tragedy no matter how it happens, cardiac arrest can occur in children either as a complication from a serious medical condition or due to an accident or sudden illness. While arrest in children is rare, currently no other therapies have been shown to improve their chances of recovering," says Dr. Charles Schleien, a pediatrician and anesthesiologist at NewYork-Presbyterian/Morgan Stanley Children's Hospital and executive vice chairman of pediatrics and professor of pediatrics and anesthesiology at Columbia University College of Physicians and Surgeons. "In this study we are aiming to see whether therapeutic hypothermia can give these children a better chance at survival and long-term quality of life."
According to a 2008 review of pediatric cardiopulmonary resuscitation in the journal Pediatrics, about 16,000 children suffer cardiac arrest each year in the United States.
Study participants will be randomly selected to either have their body cooled through therapeutic hypothermia or maintained at normal body temperature. In both groups, body heat will be adjusted using special temperature-control blankets. Those receiving hypothermia will have their body temperature reduced to between 89.6° and 93.2° Fahrenheit for two days, then slowly increased to a normal body temperature and maintained for another three days.
Co-led by Dr. Frank W. Moler at the University of Michigan C.S. Mott Children's Hospital and Dr. Michael Dean at the University of Utah, the six-year study involves a total of 34 study sites in North America.
Cardiac Arrest and Therapeutic Hypothermia
During cardiac arrest, the body's blood supply is interrupted and cells are deprived of oxygen. This stresses the body, causing the release of toxic compounds that can overwhelm the organs and result in long-term brain injury. Therapeutic hypothermia slows the body's production of these compounds, reducing risk for brain injury. The therapy has been used successfully in adult cardiac arrest patients and has been shown beneficial for newborns who have received insufficient oxygen at birth.
Columbia University Medical Center
Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The Medical Center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia's College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. Columbia University Medical Center is affiliated with NewYork-Presbyterian Hospital. For more information, please visit www.cumc.columbia.edu.
NewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, non-sectarian hospital, with 2,353 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including more than 220,000 visits to its emergency departments — more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons. For more information, visit www.nyp.org.