- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01139996
Use of Transdermal Clonidine in Trauma Patients
May 15, 2017 updated by: Memorial Health University Medical Center
A Randomized Double Blinded Placebo Controlled Trial Of Transdermal Clonidine for Adjuvant Sedation in Ventilated Trauma Patients Experiencing Delirium
This study will attempt to learn how to better treat trauma patients with delirium who are on a breathing machine.
Delirium, also known as acute, temporary brain dysfunction, is a common reason why ventilated patients can not be weaned from the breathing machine even though their lungs may be healthy enough to breathe without the machine.
The study hopes to show that by decreasing the patient's delirium it will lead to quicker weaning from the breathing machine and possibly a quicker overall recovery as well.
Patients enrolled in this study will be treated with Clonidine or placebo.
Clonidine is a drug that produces significant calming effects, decreases anxiety, and reduces pain, but with a lower incidence of delirium than other medications used in the ICU for this purpose.
Clonidine is not approved by the Federal Food and Drug Administration for treatment of delirium, but is commonly used for this purpose.
Study Overview
Detailed Description
Obtaining the appropriate level of sedation and analgesia in severely injured trauma patients admitted to the intensive care unit (ICU) can be challenging due to the diversity of injuries as well as the breadth of comorbidities present in this population.
Clonidine may be a useful adjuvant to traditional analgesics such as opioids and sedatives such as benzodiazepines and propofol.
Ventilator dependent trauma patients frequently fail extubation trials secondary to inappropriate sedation, inadequate analgesia or undertreated delirium.
Patients that fail extubation for these reasons have a potentially preventable prolonged ventilator, ICU and hospital course.
Ventilated trauma patients that meet criteria for our institution's SBT protocol and have the diagnosis of delirium will be considered for the trial if they have a documented failed SBT.
We hypothesize treatment of this patient population with transdermal Clonidine will decrease delirium in trauma patients during their ICU stay.
Patients enrolled in the treatment group will receive an oral loading dose of Clonidine 0.3 mg and placement of a Clonidine Transdermal system at a dose of 0.3-mg/day (Catapres TTS-3) covered by a patch overlay.
In 12 hours the patient will receive a second and final dose of Clonidine 0.3 mg.
The placebo group will receive a placebo oral tablet and the overlay patch only and in 12 hours they will receive a second and final placebo tablet.
A total of 120 patients will be enrolled, 60 patients in each group.
All patients will complete the study at end of Day 14 or upon discharge from the hospital, whichever comes sooner.
Ventilator times will be measured in each group as well as the prevalence of delirium by the amount of positive CAM-ICU scores over the course of the trial.
Study Type
Interventional
Enrollment (Actual)
22
Phase
- Phase 4
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
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Georgia
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Savannah, Georgia, United States, 31404
- Memorial Health University Medical Center
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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
Description
Inclusion Criteria:
- Ventilated male or female trauma patient 18 years of age or older admitted to the ICU >24 hours
- Patient must meet minimal medical criteria for potential extubation (meet criteria for being placed on spontaneous breathing trials per established MUMC SBT protocol)
- Patients must exhibit delirium as assessed by the CAM-ICU assessment tool
- Patient must be declared stable from a neurologic, respiratory and cardiovascular standpoint to receive clonidine by the attending MD
- Consent must be obtained prior to any study procedures
Exclusion Criteria:
- Patient < 18 years old
- Bradycardia (HR < 60)
- Presence of active pacemaker
- Hypotensive (<90/60)or active treatment of hypotension with vasoactive medications
- Patient actively being treated with Clonidine or dexmedetomidine
- Presence of allergy to Clonidine
- Pregnancy
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
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Transdermal Clonidine/Oral Clonidine
An oral loading dose of Clonidine 0.3 mg and placement of a Clonidine Transdermal system at a dose of 0.3 mg/day (Catapres TTS-3), with patch overlay, followed by a final dose of Clonidine 0.3 mg after 12 hours
|
An oral loading dose of Clonidine 0.3 mg and placement of Clonidine Transdermal system at a dose of 0.3-mg/day (Catapres TTS-3), with patch overlay, followed by a final dose of Clonidine 0.3mg after 12 hours
|
PLACEBO_COMPARATOR: Comparator
Placebo group will receive a placebo oral tablet and the overlay patch only and in 12 hours they will receive a second and final placebo tablet
|
A placebo oral tablet and the overlay patch only and in 12 hours they will receive a second and final tablet
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Duration of Mechanical Ventilation Following Administration of the First Dose of Clonidine or Placebo
Time Frame: 2 or more years
|
data were not collected
|
2 or more years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence and Duration in Hours of Delirium Currently Used
Time Frame: 2 or more years
|
As assessed by the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) score Data were not collected
|
2 or more years
|
Time to Pass First SBT Following Administration of the First Dose of Clonidine or Placebo
Time Frame: 2 or more years
|
Hours. data were not collected
|
2 or more years
|
Mean Incidence and Duration of Delirium
Time Frame: 2 or more years
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As assessed by daily CAM score currently used.
data were not collected
|
2 or more years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this 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
May 1, 2010
Primary Completion (ACTUAL)
August 1, 2012
Study Completion (ACTUAL)
August 1, 2012
Study Registration Dates
First Submitted
June 7, 2010
First Submitted That Met QC Criteria
June 8, 2010
First Posted (ESTIMATE)
June 9, 2010
Study Record Updates
Last Update Posted (ACTUAL)
June 14, 2017
Last Update Submitted That Met QC Criteria
May 15, 2017
Last Verified
May 1, 2017
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Nervous System Diseases
- Neurologic Manifestations
- Confusion
- Neurobehavioral Manifestations
- Neurocognitive Disorders
- Delirium
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Antihypertensive Agents
- Autonomic Agents
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Adrenergic alpha-2 Receptor Agonists
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Sympatholytics
- Clonidine
Other Study ID Numbers
- MHUMC-2010-04-02
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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University Hospital, Basel, SwitzerlandInnosuisse - Swiss Innovation AgencyRecruitingPostoperative Delirium (POD)Switzerland
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