Conflict of interest: None declared.
Cooling in intracerebral hemorrhage (CINCH) trial: protocol of a randomized German–Austrian clinical trial
Article first published online: 20 JAN 2012
© 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization
International Journal of Stroke
Volume 7, Issue 2, pages 168–172, February 2012
How to Cite
Kollmar, R., Juettler, E., Huttner, H. B., Dörfler, A., Staykov, D., Kallmuenzer, B., Schmutzhard, E., Schwab, S., Broessner, G. and for the CINCH investigators (2012), Cooling in intracerebral hemorrhage (CINCH) trial: protocol of a randomized German–Austrian clinical trial. International Journal of Stroke, 7: 168–172. doi: 10.1111/j.1747-4949.2011.00707.x
- Issue published online: 20 JAN 2012
- Article first published online: 20 JAN 2012
- intracerebral hemorrhage;
Intracerebral hemorrhage accounts for up to 15% of all strokes and is frequently associated with poor functional outcome and high mortality. So far, there is no clear evidence for a specific therapy, apart from general stroke unit or neurointensive care and management of secondary complications. Promising experimental and pilot clinical data support the use of therapeutic hypothermia after intracerebral hemorrhage.
The study aims to determine if therapeutic hypothermia improves survival rates and reduces cerebral lesion volume after large intracerebral hemorrhage compared with conventional treatment.
Material and methods
The Cooling in IntraCerebral Hemorrhage trial is a prospective, multicenter, interventional, randomized, parallel, two-arm (1 : 1) phase II trial with blinded end-point adjudication. Enrolment: 50 patients (age: 18 to 65 years) with large (25 to 64 ml on cranial computertomography), primary intracerebral hemorrhage of the basal ganglia or thalamus within 6 to 18 h after symptom onset are randomly allocated to therapeutic hypothermia for eight-days or conventional temperature management. In the therapeutic hypothermia group, a target temperature of 35·0°C is achieved by endovascular catheters and followed by slow controlled rewarming. Data analysis is based on the intent-to-treat population. The primary outcome measure of the study is the development in total lesion volume on cranial computertomography (intracerebral hemorrhage plus perihemorrhagic edema on day 8 ± 0·5 and day 11 ± 0·5 after intracerebral hemorrhage) and the mortality after 30 days. Secondary end-points are the in-hospital mortality, mortality, and functional outcome (modified Rankin Scale and Barthel-Index) after 90 and 180 days. Safety measures include any adverse events associated with therapeutic hypothermia.
In the face of a lack of evidence-based therapies for patients with large intracerebral hemorrhage, new promising approaches are desperately needed, but need evaluation in randomized controlled trials.
The results of Cooling in IntraCerebral Hemorrhage trial are believed to directly influence future therapy of large intracerebral hemorrhage.