Ketamine Efficacy for Acute Severe Bronchospasm in ICU: MACANUDO Trial (MACANUDO)
Ketamine Efficacy for Acute Severe Bronchospasm in Mechanically Ventilated-critically Ill Patients: a Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Wagner Nedel, MD, MSc
- Phone Number: +555133572237
- Email: wagnernedel@uol.com.br
Study Locations
-
-
-
Porto Alegre, Brazil
- Hospital Nossa Senhora da Conceicao
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- patients with acute exacerbation of COPD or status asthmaticus, undergoing controlled mechanical ventilation
- acute bronchospasm, defined as airway resistance value (Rsr max) greater than 12, use of inhaled therapy with bronchodilators and systemic corticosteroids
- patients requiring the use of continuous intravenous sedation for optimization of ventilation
Exclusion Criteria:
- contraindication or history of previous adverse events with the use of the studied drugs
- other diagnostic potential Rsr increase of not causing bronchospasm (bronchial obstruction, acute respiratory distress syndrome adult, pulmonary fibrosis)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Ketamine
Intravenous ketamine infusion: bolus 2mg per kg and continuous infusion (2mg/kg/h)
|
Active treatment
|
|
Active Comparator: Fentanyl
Fentanyl: bolus infusion 1μg per kg and continuous infusion (1μg/kg/h)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
bronchospasm improvement
Time Frame: 3 hours post beginning of drug infusion
|
Maximal airway resistance reduction in hour 3-post beginning of drug infusion
|
3 hours post beginning of drug infusion
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
bronchospasm improvement
Time Frame: 24 hours post beginning of drug infusion
|
Maximal airway resistance reduction in 24th hour post beginning of drug infusion
|
24 hours post beginning of drug infusion
|
|
Time to weaning
Time Frame: Time (in days) to first spontaneous breathing trial post randomization up to 28 days
|
Time (in days) to first spontaneous breathing trial post randomization up to 28 days
|
Time (in days) to first spontaneous breathing trial post randomization up to 28 days
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Dynamic complacence improvement
Time Frame: 3 hours and 24 hours post beginning of drug infusion
|
3 hours and 24 hours post beginning of drug infusion
|
|
|
Air trapping improvement
Time Frame: 3 hours and 24 hours post beginning of drug infusion
|
intrinsic PEEP reduction in 3 and 24h post beginning of drug infusion
|
3 hours and 24 hours post beginning of drug infusion
|
|
Heart rate
Time Frame: 3 hours and 24 hours post beginning of drug infusion
|
Heart rate in 3 hours and 24h post beginning of drug infusion
|
3 hours and 24 hours post beginning of drug infusion
|
|
Blood pressure
Time Frame: 3 hours and 24 hours post beginning of drug infusion
|
Blood pressure variation in 3 hours and 24hours post beginning of drug infusion
|
3 hours and 24 hours post beginning of drug infusion
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Miller AC, Jamin CT, Elamin EM. Continuous intravenous infusion of ketamine for maintenance sedation. Minerva Anestesiol. 2011 Aug;77(8):812-20.
- Allen JY, Macias CG. The efficacy of ketamine in pediatric emergency department patients who present with acute severe asthma. Ann Emerg Med. 2005 Jul;46(1):43-50. doi: 10.1016/j.annemergmed.2005.02.024.
- Barbas CS, Isola AM, Farias AM, Cavalcanti AB, Gama AM, Duarte AC, Vianna A, Serpa Neto A, Bravim Bde A, Pinheiro Bdo V, Mazza BF, Carvalho CR, Toufen Junior C, David CM, Taniguchi C, Mazza DD, Dragosavac D, Toledo DO, Costa EL, Caser EB, Silva E, Amorim FF, Saddy F, Galas FR, Silva GS, Matos GF, Emmerich JC, Valiatti JL, Teles JM, Victorino JA, Ferreira JC, Prodomo LP, Hajjar LA, Martins LC, Malbouisson LM, Vargas MA, Reis MA, Amato MB, Holanda MA, Park M, Jacomelli M, Tavares M, Damasceno MC, Assuncao MS, Damasceno MP, Youssef NC, Teixeira PJ, Caruso P, Duarte PA, Messeder O, Eid RC, Rodrigues RG, Jesus RF, Kairalla RA, Justino S, Nemer SN, Romero SB, Amado VM. Brazilian recommendations of mechanical ventilation 2013. Part I. Rev Bras Ter Intensiva. 2014 Apr-Jun;26(2):89-121. doi: 10.5935/0103-507x.20140017.
- Rowe BH, Sevcik W, Villa-Roel C. Management of severe acute asthma in the emergency department. Curr Opin Crit Care. 2011 Aug;17(4):335-41. doi: 10.1097/MCC.0b013e328348bf09.
- Heshmati F, Zeinali MB, Noroozinia H, Abbacivash R, Mahoori A. Use of ketamine in severe status asthmaticus in intensive care unit. Iran J Allergy Asthma Immunol. 2003 Dec;2(4):175-80.
- Howton JC, Rose J, Duffy S, Zoltanski T, Levitt MA. Randomized, double-blind, placebo-controlled trial of intravenous ketamine in acute asthma. Ann Emerg Med. 1996 Feb;27(2):170-5. doi: 10.1016/s0196-0644(96)70319-0.
- Goyal S, Agrawal A. Ketamine in status asthmaticus: A review. Indian J Crit Care Med. 2013 May;17(3):154-61. doi: 10.4103/0972-5229.117048.
- Abu-Hijleh M, El-Sameed Y, Eldridge K, Vadia E, Chiu H, Dreyfuss Z, Al Rabadi LS. Linear probe endobronchial ultrasound bronchoscopy with guided transbronchial needle aspiration (EBUS-TBNA) in the evaluation of mediastinal and hilar pathology: introducing the procedure to a teaching institution. Lung. 2013 Feb;191(1):109-15. doi: 10.1007/s00408-012-9439-z. Epub 2012 Dec 4.
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 (Estimated)
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
- Pathologic Processes
- Respiratory Tract Diseases
- Disease Attributes
- Bronchial Diseases
- Critical Illness
- Bronchial Spasm
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anesthetics, Dissociative
- Anesthetics, Intravenous
- Anesthetics, General
- Anesthetics
- Excitatory Amino Acid Antagonists
- Excitatory Amino Acid Agents
- Analgesics, Opioid
- Narcotics
- Adjuvants, Anesthesia
- Ketamine
- Fentanyl
Other Study ID Numbers
Other Study ID Numbers
- 42324015.0.0000.5530
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