Clinical Trial: Cardiogenic Shock Intravascular Cooling Trial

Study Status: Not yet recruiting
Recruit Status: Not yet recruiting
Study Type: Interventional

Official Title: Cardiogenic Shock Intravascular Cooling Trial (CHILL-SHOCK)

Brief Summary: The purpose of the study is to compare patients with cardiogenic shock who receive standard therapy plus therapeutic hypothermia (TH) to patients with cardiogenic shock who receive standard medical therapy alone in order to assess the safety of TH in patients with cardiogenic shock. This study will also help understand the physiologic effects of TH in patients with cardiogenic shock. This will be a pilot study to establish the initial safety of TH and to assess tolerability of TH in this patient population.

Detailed Summary:

This is an unblinded pilot study of 20 patients randomized to either TH plus standard medical care or to standard medical care alone. All patients will undergo pulmonary artery (PA) catheter placement as part of the standard of care for management of cardiogenic shock. Data from the PA catheter is vital in monitoring real-time hemodynamics, initiating vasopressors/inotropes, assessing the response to the therapies, and possible need for escalation of therapy.

For patients randomized to TH, cooling to 32-34°C will then be initiated and maintained for 24 hours using the FDA-approved Intravascular Temperature Management (IVTM™) System with the 9.3 French Quattro® Catheter. The IVTM™ System along with the Quattro® Catheter are currently FDA-approved for use in cardiac surgery patients to achieve and maintain normothermia during surgery and in recovery and to induce, maintain, and reverse mild hypothermia in neurosurgery patients during surgery and in recovery. The IVTM™ System and Quattro® Catheter are not, however, currently FDA-approved to achieve therapeutic hypothermia in cardiogenic shock patients. TH is achieved by circulating normal saline in a closed system through the catheter. The temperature is measured and adjustments are made by the thermal regulation system to automatically maintain target temperature. The target temperature is achieved within 2-3 hours of initiation of TH. Rewarming is accomplished using the same balloon catheter system and heat exchange occurs without infusion of any saline or fluids.

Standard medical therapy for all patients will be based on the current recommendations for management of cardiogenic shock. This includes inotropic therapy for cardiac support, vasopressor therapy to achieve target blood pressure, diuretics for volume removal, and mechanical c
Sponsor: University of Chicago

Current Primary Outcome:

  • Episodes of arrhythmia [ Time Frame: up to 96 hours ]
    requiring intervention (medical therapy or therapy with temporary pacemaker)
  • Bleeding [ Time Frame: up to 96 hours ]
    requiring transfusions as a direct result of the cooling catheter insertion or secondary to resulting coagulopathy
  • Infection [ Time Frame: up to 96 hours ]
    confirmed with 2 positive blood cultures


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Changes in cardiac output/cardiac index [ Time Frame: up to 96 hours ]
  • Changes in pulmonary capillary wedge pressure (PCWP) [ Time Frame: up to 96 hours ]
  • Changes in systemic vascular resistance (SVR) [ Time Frame: up to 96 hours ]
  • Changes in mixed venous oxygen saturation (MVO2) [ Time Frame: up to 96 hours ]
  • Changes in cardiac power index [ Time Frame: up to 96 hours ]
  • Cumulative vasopressor and inotrope dose requirements [ Time Frame: up to 96 hours ]
    number of vasoactive and/or inotropic drugs used
  • ECG changes [ Time Frame: up to 18-24 hours ]
    percent change in ejection fraction
  • All-cause mortality [ Time Frame: up to 96 hours, 30 days, and 90 days ]


Original Secondary Outcome: Same as current

Information By: University of Chicago

Dates:
Date Received: May 1, 2017
Date Started: May 2017
Date Completion: May 2020
Last Updated: May 2, 2017
Last Verified: May 2017