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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT01020916
Registration number
NCT01020916
Ethics application status
Date submitted
25/11/2009
Date registered
26/11/2009
Date last updated
10/07/2013
Titles & IDs
Public title
Target Temperature Management After Cardiac Arrest
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Scientific title
Target Temperature Management 33°C Versus 36°C After Out-of-hospital Cardiac Arrest, a Randomised, Parallel Groups, Assessor Blinded Clinical Trial
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Secondary ID [1]
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TTM-1
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Universal Trial Number (UTN)
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Trial acronym
TTM
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Out-of-hospital Cardiac Arrest
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Condition category
Condition code
Cardiovascular
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Coronary heart disease
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Cardiovascular
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Surgery - Target temperature 36°C
Treatment: Surgery - Target Temperature 33°C
Experimental: Target Temperature 33°C -
Active Comparator: Target Temperature 36°C -
Treatment: Surgery: Target temperature 36°C
In hospital target temperature management to achieve a core body temperature of 36°C for 24 hours
Treatment: Surgery: Target Temperature 33°C
In hospital target temperature management to achieve a core body temperature of 33°C for 24 hours
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Intervention code [1]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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All-cause mortality
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Assessment method [1]
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Timepoint [1]
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Maximum follow-up with a minimum of 180 days
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Secondary outcome [1]
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Composite outcome of all-cause mortality and poor neurological function (CPC 3 and 4) and composite outcome of all-cause mortality and poor neurological function (modified Rankin Scale 4 and 5)
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Assessment method [1]
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Timepoint [1]
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180 days
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Secondary outcome [2]
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Bleeding
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Assessment method [2]
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Timepoint [2]
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During day 1-7 of intensive care treatment
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Secondary outcome [3]
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Neurological function
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Assessment method [3]
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Cerebral Performance Category, Modified Rankin Scale
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Timepoint [3]
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180 days
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Secondary outcome [4]
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Pneumonia
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Assessment method [4]
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Timepoint [4]
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During day 1-7 of intensive care treatment
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Secondary outcome [5]
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Electrolyte disorders
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Assessment method [5]
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Timepoint [5]
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During day 1-7 of intensive care treatment
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Secondary outcome [6]
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Hyperglycaemia > 10 mmol/l
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Assessment method [6]
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Timepoint [6]
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During day 1-7 of intensive care treatment
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Secondary outcome [7]
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Hypoglycemia < 3mmol/l
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Assessment method [7]
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Timepoint [7]
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During day 1-7 of intensive care treatment
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Secondary outcome [8]
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Cardiac arrhythmia
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Assessment method [8]
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Timepoint [8]
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During day 1-7 of intensive care treatment
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Secondary outcome [9]
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The need for renal replacement therapy
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Assessment method [9]
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Timepoint [9]
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During day 1-7 of intensive care treatment
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Secondary outcome [10]
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Landmark all-cause mortality
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Assessment method [10]
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Timepoint [10]
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180 days
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Secondary outcome [11]
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Cerebral Performance Category (CPC)
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Assessment method [11]
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CPC 1,2,3,4,5
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Timepoint [11]
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180 days
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Secondary outcome [12]
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Modified Rankin Scale (mRS)
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Assessment method [12]
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mRS 1,2,3,4,5,6
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Timepoint [12]
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180 days
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Eligibility
Key inclusion criteria
- Age = 18 years old
- Out-of-hospital cardiac arrest (OHCA) of presumed cardiac cause
- Return of spontaneous circulation (ROSC)
- Unconsciousness (Glasgow Coma Score < 8) (patients not able to obey verbal
commands)after sustained ROSC
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- In-hospital cardiac arrest
- OHCA of presumed non-cardiac cause, e.g. after trauma or dissection/rupture of major
artery OR Cardiac arrest caused by initial hypoxia (i.e. drowning, suffocation,
hanging).
- Known bleeding diathesis (medically induced coagulopathy (e.g warfarin, clopidogrel)
does not exclude the patient).
- Suspected or confirmed acute intracranial bleeding
- Suspected or confirmed acute stroke
- Unwitnessed asystole
- Known limitations in therapy and Do Not Resuscitate-order
- Known disease making 180 days survival unlikely
- Known pre-arrest CPC 3 or 4
- Temperature < 30°C on admission
- > 4 hours (240 minutes) from ROSC to screening
- Systolic blood pressure < 80 mm Hg in spite of fluid loading/vasopressor and/or
inotropic medication/intra aortic balloon pump#
- If the systolic blood pressure (SBP) is recovering during the inclusion window
(220 minutes) the patient can be included.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/11/2010
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/07/2013
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Sample size
Target
950
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Liverpool Hospital - Sydney
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Recruitment hospital [2]
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North Shore Hospital - Sydney
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Recruitment hospital [3]
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St George Hospital - Sydney
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Recruitment postcode(s) [1]
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- Sydney
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Recruitment outside Australia
Country [1]
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Czech Republic
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State/province [1]
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Prague
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Denmark
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State/province [2]
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Copenhagen
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Italy
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State/province [3]
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Genova
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Country [4]
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Italy
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State/province [4]
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Pordenone
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Country [5]
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Italy
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State/province [5]
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Trieste
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Country [6]
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Luxembourg
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State/province [6]
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Luxembourg
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Country [7]
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Netherlands
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State/province [7]
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Amsterdam
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Country [8]
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Netherlands
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State/province [8]
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Arnhem
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Country [9]
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Netherlands
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State/province [9]
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Leeuwarden
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Country [10]
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Norway
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State/province [10]
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Bergen
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Norway
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State/province [11]
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Oslo
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Country [12]
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Sweden
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State/province [12]
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Gothenburg
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Country [13]
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Sweden
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State/province [13]
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Helsingborg
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Country [14]
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Sweden
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State/province [14]
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Karlstad
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Country [15]
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Sweden
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State/province [15]
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Kungälv
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Country [16]
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Sweden
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State/province [16]
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Linköping
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Country [17]
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Sweden
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State/province [17]
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Lund
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Country [18]
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Sweden
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State/province [18]
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Malmö
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Country [19]
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Sweden
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State/province [19]
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Norrköping
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Country [20]
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Sweden
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State/province [20]
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Trollhättan/Vänersborg
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Country [21]
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Sweden
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State/province [21]
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Örebro
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Country [22]
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Switzerland
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State/province [22]
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Geneva
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Country [23]
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Switzerland
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State/province [23]
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St Gallen
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Country [24]
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United Kingdom
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State/province [24]
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Bournemouth
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United Kingdom
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State/province [25]
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Cardiff
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Country [26]
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United Kingdom
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London
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Country [27]
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United Kingdom
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State/province [27]
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Reading
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Funding & Sponsors
Primary sponsor type
Other
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Name
Niklas Nielsen
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Address
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Other collaborator category [1]
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Other
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Name [1]
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Scandinavian Critical Care Trials Group
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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Copenhagen Trial Unit, Center for Clinical Intervention Research
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Address [2]
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Country [2]
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Other collaborator category [3]
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Other
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Name [3]
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Lund University
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Address [3]
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Country [3]
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Other collaborator category [4]
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Other
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Name [4]
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The George Institute for Global Health, Australia
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Address [4]
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Country [4]
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Ethics approval
Ethics application status
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Summary
Brief summary
Experimental studies and previous clinical trials suggest an improvement in mortality and
neurological function with hypothermia after cardiac arrest. However, the accrued evidence is
inconclusive and associated with risks of systematic error, design error and random error.
Elevated body temperature after cardiac arrest is associated with a worse outcome. Previous
trials did not treat elevated body temperature in the control groups. The optimal target
temperature for post-resuscitation care is not known. The primary purpose with the TTM-trial
is to evaluate if there are differences in all-cause mortality, neurological function and
adverse events between a target temperature management at 33°C and 36°C for 24 hours
following return of spontaneous circulation after cardiac arrest.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT01020916
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Trial related presentations / publications
Nielsen N, Friberg H, Gluud C, Herlitz J, Wetterslev J. Hypothermia after cardiac arrest should be further evaluated--a systematic review of randomised trials with meta-analysis and trial sequential analysis. Int J Cardiol. 2011 Sep 15;151(3):333-41. doi: 10.1016/j.ijcard.2010.06.008. Epub 2010 Jul 1.
Nielsen N, Hovdenes J, Nilsson F, Rubertsson S, Stammet P, Sunde K, Valsson F, Wanscher M, Friberg H; Hypothermia Network. Outcome, timing and adverse events in therapeutic hypothermia after out-of-hospital cardiac arrest. Acta Anaesthesiol Scand. 2009 Aug;53(7):926-34. doi: 10.1111/j.1399-6576.2009.02021.x. Epub 2009 Jun 22.
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Public notes
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Contacts
Principal investigator
Name
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Niklas Nielsen, MD, PhD
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Address
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Helsingborgs lasarett, Region Skåne, Sweden
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Fax
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Email
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT01020916
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