Research

Freezing Out Brain Injury

To the average person, hypothermia, or the condition of an abnormally low body temperature is something to be avoided. But when it comes to treating children with traumatic brain injuries, hypothermia therapy may prove to be a lifesaver.

An $11.5-million nationwide clinical trial in which Children's Hospital of Pittsburgh of UPMC has a leadership role, will determine if lowering patient temperature to about 32 degrees Celsius for 48 hours can thwart the cascade of events that lead to brain swelling after injury.

Researchers at 12 sites throughout the United States are participating in this study, which will enroll 340 children up to age 16. Initiated in 2007, the five-year, Phase III randomized trial is being funded by the National Institute of Neurological Disorders and Stroke. In Pittsburgh, Children’s serves as the clinical site for the study and the University of Pittsburgh serves as the coordinating site. The study is being led by P. David Adelson, MD, FACS, FAAP, who initiated the project while director of Children’s Pediatric Neurotrauma Center.

“The belief is that cooling impacts the cascade of events that leads to brain swelling,” said Dr. Adelson who now heads a pediatric unit at Phoenix Children's Hospital. “Reducing brain swelling potentially could prevent further injury.“

Patients in the study selected to receive hypothermia therapy will be cooled to between 32–33 degrees Celsius (89–90 degrees Fahrenheit), using special cooling blankets and/or cooled saline injected intravenously. They will be cooled for 48 hours and then followed by researchers for one year to track outcomes, with a battery of tests being conducted at six and 12 months following injury.

A previous Phase II clinical trial of induced hypothermia therapy led by Dr. Adelson at Children’s found that moderate hypothermia therapy is safe and may potentially improve outcome. Results of that study were published in the journal Neurosurgery in April 2005.

“We’ve proven this therapy is safe. Now if we can determine that it is effective, it would be a major breakthrough because currently there are very limited treatments that improve outcome following traumatic brain injury in children,” Dr. Adelson said.

Last Update
May 29, 2009

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