Non-interventional Comparison of Sedatives on Weaning From Mechanical Ventilation in Intensive Care Patients (NICEWEAN)

September 4, 2019 updated by: Orion Corporation, Orion Pharma
The purpose of this study is to determine whether the use of different sedatives affect the weaning process from mechanical ventilation in intensive care patients.

Study Overview

Status

Terminated

Conditions

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

Observational

Enrollment (Actual)

155

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

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

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

Adult general intensive care patients Need of mechanical ventilation >24 hours Need of light to moderate sedation

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

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / 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

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

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

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Carl-Johan Wickerts, MD, Danderyds Hospital, Danderyd, Sweden

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2012

Primary Completion (Actual)

November 1, 2015

Study Completion (Actual)

November 1, 2015

Study Registration Dates

First Submitted

October 12, 2012

First Submitted That Met QC Criteria

October 15, 2012

First Posted (Estimate)

October 16, 2012

Study Record Updates

Last Update Posted (Actual)

September 6, 2019

Last Update Submitted That Met QC Criteria

September 4, 2019

Last Verified

September 1, 2019

More Information

Terms related to this study

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)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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