Non-interventional Comparison of Sedatives on Weaning From Mechanical Ventilation in Intensive Care Patients (NICEWEAN)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Traditionally patients with ongoing mechanical ventilation have been sedated to assure absence of pain, anxiety and to provide comfort. Unfortunately this approach might have negative consequences such as prolonged time for mechanical ventilation, length of stay in the ICU and hospital.
In this study, the investigators would like to investigate (in an exploratory way due to the non-interventional setup) whether weaning from mechanical ventilation will be affected by the choice of sedatives - including dexmedetomidine, midazolam and propofol. This study also aims at investigating how the choice of primary sedative will affect delirium/anxiety, need of other medications (sedatives, analgesics, anti-psychotics), quality of life after ICU and the presence of Post-Traumatic Stress Disorder. In addition, the investigators aim at receiving information from the caregivers on their ICU experience, as recent data imply that not only the ICU patient but also the caregiver suffer from PTSD after the ICU stay.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
-
Danderyd, Sweden, SE18288
- Danderyds Hospital Anestesi- och intensivvårdskliniken
-
Stockholm, Sweden, SE11281
- Capio S:t Goran Hospital, Anestesikliniken
-
Örebro, Sweden, SE70185
- Örebro University Hospital, Anestesi- och intensivvårdskliniken
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Admitted to a general ICU ward
- ≥ 18years
- Intubated and mechanically ventilated for at least 24 hours
- Need of light to moderate sedation (corresponding to RASS 0 - (-3) or MAAS 2-3)
- Sedated with dexmedetomidine, midazolam and/or propofol
- Good knowledge in Swedish language
- Signed informed consent
Exclusion criteria:
- Lack of fulfilling prescribed sedation regime
- Estimated high risk of death during the study period, according to investigator (roughly equal to estimated mortality rate (EMR) > 80% )
- Tracheotomy
- Change in sedative drugs since the "fit for weaning" time point
- Use of other alpha-2 agonists (clonidine) during ICU stay
- Positive pregnancy test or currently lactating/ known pregnancy or lactation
- Participation in other study involving use of a pharmacologically active compound
- Patients with limitations in therapy
- Otherwise unable to fulfill the study, according to investigator's opinion
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Dexmedetomidine
Here, patients to be included are those being sedated with dexmedetomidine as primary sedative.
|
Patient are given standard of care
|
|
Propofol
Here, patients to be included are those being sedated with propofol as primary sedative.
|
Patient are given standard of care
|
|
Midazolam
Here, patients to be included are those being sedated with midazolam as primary sedative
|
Patient are given standard of care
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
The time point from when the patient is considered "fit for weaning" to the actual time point for extubation
Time Frame: 30 days
|
30 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time-point for patient being considered "fit for extubation"
Time Frame: 30 days
|
30 days
|
|
|
Total time in mechanical ventilation
Time Frame: 30 days
|
30 days
|
|
|
Extubation failure (re-intubation within 24 hours)
Time Frame: 24 hours
|
24 hours
|
|
|
Anxiety/delirium assessments
Time Frame: 30 days
|
RASS/MAAS sedation scales and ICDSC/CAM-ICU delirium assessments methods are used, as appropriate
|
30 days
|
|
Length of ICU stay (actual time of discharge)
Time Frame: 30 days
|
30 days
|
|
|
QoL (15D)
Time Frame: 2-4 months post-ICU discharge
|
2-4 months post-ICU discharge
|
|
|
Post-Traumatic Stress Disorder assessment - PTSS14 questionnaire
Time Frame: 2-4 months post-ICU discharge
|
This assessment will be offered to the ICU patients but also to their caregivers.
|
2-4 months post-ICU discharge
|
|
Total duration of sedation
Time Frame: 30 days
|
30 days
|
|
|
Number of days using opioids
Time Frame: 30 days
|
30 days
|
|
|
Number of days using antipsychotic/neuroleptic drugs
Time Frame: 30 days
|
30 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Carl-Johan Wickerts, MD, Danderyds Hospital, Danderyd, Sweden
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 3005022
- Dnr 2012/628-31/4 (Other Identifier: Ethical Review Board, Stockholm Region)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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