The Impact of Ramelteon on Sleep and Delirium in Patients Who Undergo Pulmonary Thromboendarterectomy (PTE) Surgery
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH) who are admitted to UCSD for a planned PTE surgery.
- Age > 18 years
Exclusion Criteria:
- Pregnancy
- Cirrhosis of any etiology
- Current use of any atypical antipsychotic including Fluvoxamine (contra-indicated with Ramelteon)
- Any contraindication to EEG/Sleep recording
- Non-English speaking (who are unable to complete delirium questionnaires)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: TRIPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
PLACEBO_COMPARATOR: Placebo
Patients will receive a Placebo tablet every evening.
|
|
|
ACTIVE_COMPARATOR: Ramelteon
Patients will receive Ramelteon 8mg every evening.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Duration of Delirium
Time Frame: Twice daily for up to 10 days
|
Measured twice daily during the ICU stay using the Confusions Assessment Method instrument.
|
Twice daily for up to 10 days
|
|
Total Duration of Sleep
Time Frame: Daily for up to 10 days
|
Participants wore an actigraphy device on their wrist for the duration of their ICU stay.
This device continuously measures activity, and thus estimates sleep time.
|
Daily for up to 10 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Delirium
Time Frame: Twice daily for up to 10 days
|
Measured twice daily over the course of the ICU stay using the Confusion Assessment Method instrument
|
Twice daily for up to 10 days
|
|
Average Daily Critical Care Pain Observation Tool (CPOT)
Time Frame: 10 days
|
average daily pain level using the CPOT Participants can score from 0 to 6 on the CPOT scale, with 0 being no pain (calm, comfortable), and 6 representing significant pain/agitation.
|
10 days
|
|
Length of Hospital Stay
Time Frame: Duration of hospital admission
|
Duration of hospital admission
|
|
|
Length of ICU Stay
Time Frame: Duration of hospital admission
|
Duration of hospital admission
|
|
|
Measures of Light Quality in the Patient's Room
Time Frame: 3 days
|
Light meter placed at bedside in patient room; this meter measured and recorded the light level in lux for ever minutes.
|
3 days
|
|
Measures of the Sound Levels in the Patient's Room
Time Frame: 3 days
|
Sound meter was placed at bedside in each patient room.
This meter measured and recorded the sound level in decibels every two seconds.
|
3 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Robert Owens, 8686577118
Publications and helpful links
General Publications
- Al-Aama T, Brymer C, Gutmanis I, Woolmore-Goodwin SM, Esbaugh J, Dasgupta M. Melatonin decreases delirium in elderly patients: a randomized, placebo-controlled trial. Int J Geriatr Psychiatry. 2011 Jul;26(7):687-94. doi: 10.1002/gps.2582. Epub 2010 Sep 15. Erratum In: Int J Geriatr Psychiatry. 2014 May;29(5):550.
- Bellapart J, Boots R. Potential use of melatonin in sleep and delirium in the critically ill. Br J Anaesth. 2012 Apr;108(4):572-80. doi: 10.1093/bja/aes035.
- Hatta K, Kishi Y, Wada K, Takeuchi T, Odawara T, Usui C, Nakamura H; DELIRIA-J Group. Preventive effects of ramelteon on delirium: a randomized placebo-controlled trial. JAMA Psychiatry. 2014 Apr;71(4):397-403. doi: 10.1001/jamapsychiatry.2013.3320.
- Jaiswal SJ, Vyas AD, Heisel AJ, Ackula H, Aggarwal A, Kim NH, Kerr KM, Madani M, Pretorius V, Auger WR, Fernandes TM, Malhotra A, Owens RL. Ramelteon for Prevention of Postoperative Delirium: A Randomized Controlled Trial in Patients Undergoing Elective Pulmonary Thromboendarterectomy. Crit Care Med. 2019 Dec;47(12):1751-1758. doi: 10.1097/CCM.0000000000004004.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ANTICIPATED)
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
- 151294
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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