- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04611425
REmimazolam Infusion in the Context of Hypnotic Shortage in the Critical Care Unit During the Pandemic of COVID-19: REHSCU Study (REHSCU)
REmimazolam Infusion in the Context of Hypnotic Shortage in the Critical Care Unit During the Pandemic of COVID-19. The Non-randomized, Non-controlled, Pilot, Open, Mono-centric REHSCU Study
Study Overview
Status
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Nantes, France
- CHU de Nantes
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients at least 18 years old
- Inclusion in the first 96 hours after ICU admission, after clinical stabilization according to the attending physician's discretion.
- Expected duration of general anaesthesia ≥ 24 hours
Exclusion Criteria:
- Patients more than 85 years-old
- Refusal to participate
- Severe patients with moribund state within the 24 hours after admission to the ICU
- Withdrawal of Life Sustaining Therapies within the 24 hours after admission to the ICU
- Any pregnant or breast-feeding patient,
- Patients with known anaphylactic reactions to benzodiazepines, flumazenil, or a medical condition such that these agents are contraindicated (according to local label)
- Patients with allergy/hypersensitivity to bovine lactose, dextran or any other excipient in the remimazolam product
- Presence of acute alcoholic or illicit drug intoxication or benzodiazepine intoxication
- Inclusion in another clinical (drug) trial
- Patient under guardianship or trusteeship
- Patient under judicial protection
- Severe hepatic impairment defined as a Child-Pugh score > 10.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Remimazolam
Patients will receive an infusion of Remimazolam for a maximum duration of 48 hours. The dose of Remimazolam will be adapted according to our ICU protocol of analgesia-sedation management, based on validated scale (Richmond Assessment Sedation Scale) |
Patients will receive an infusion of Remimazolam for a maximum duration of 48 hours.
The dose of Remimazolam will be adapted according to the ICU units protocol of analgesia-sedation management, based on validated scale (Richmond Assessment Sedation Scale).
Owing to previous data gathered through a previous study in Japan, the initial dose of infusion will be within a 0.2-0.5 mg/min range.
The dose of Remimazolam can be increased or decreased by 0.1mg/min when needed.
The maximum dose of Remimazolam will be set at 1 mg/min.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
composite endpoint including a combination of cardio-vascular and sedation events, from baseline (before infusion) to 8 hours, after the beginning of Remimazolam infusion
Time Frame: 8 hours after the beginning of infusion.
|
For Safety: Cardiovascular event: Hypotension will be defined as a Mean Arterial Pressure ≤65mmHg or an increase ≥50% of the dose of norepinephrine (if appropriate), sustained over one hour after the beginning of Remimazolam. For Efficacy: Sedation event: the investigator will check if Remimazolam provides an adequate level of sedation assessed with the Richmond Assessment Sedation Scale. The level of sedation will be set by the attending physician and is usually set at-1/0. The investigator will also monitor the need to use standard hypnotic drugs within this time frame as further medication (propofol, midazolam, dexmedetomidine) in case of Remimazolam inefficacy (Richmond Assessment Sedation Scale). |
8 hours after the beginning of infusion.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Adverse Events (all grades), related to Remimazolam.
Time Frame: 5 days
|
An exhaustive monitoring of Adverse Events will be performed from Day-0 (inclusion), Day-1 and Day-2 (during infusion), to Day-5 (3 days after discontinuation).
|
5 days
|
Heart rate
Time Frame: 3 days
|
Hemodynamic stability follow-up of heart rate, from day1 to day3.
|
3 days
|
Arterial pressure
Time Frame: 3 days
|
Hemodynamic stability follow-up with systolic, diastolic and mean arterial pressure from day1 to day3.
|
3 days
|
Dose of norepinephrine
Time Frame: 3 days
|
Hemodynamic stability follow-up with the dose of norepinephrine from day1 to day3.
|
3 days
|
Electrocardiogram (ECG)
Time Frame: 3 days
|
Hemodynamic stability follow-up with electrocardiogram from day1 to day3.
|
3 days
|
Sedation.
Time Frame: 3 days
|
The level of sedation will be assessed with clinical scale (Richmond Assessment Sedation Scale, scores from -5:unarousable to+4 : Combative or Bispectral Index, index from 100 (awake subject) to 0 (very deep sleep) .From day1 to day3.
|
3 days
|
Other sedatives.
Time Frame: 3 days
|
The use or switch to other sedatives (midazolam, dexmedetomidine, propofol) in case of remimazolam inefficacy, will be monitored, from day1 to day3.
|
3 days
|
Wake-up time.
Time Frame: 3 days
|
In minutes, defined as Richmond Assessment Sedation Scale 4 of -1/0, only in non-neurologic patients and if general anesthesia is definitely stopped at the end of remimazolam infusion.
|
3 days
|
Pharmacokinetics of Remimazolam and its metabolites (CNS 7054): Maximum Plasma Concentration.
Time Frame: 3 days
|
maximum plasma concentration of Remimazolam and its metabolites, measured during the infusion and at the end.
9 Pharmacokinetic blood samplings during the infusion, and at Day-3, after Remimazolam discontinuation.
In total 9 (nine) blood samples of 2 ml will be collected during the 48-hour infusion and during elimination phase (up to 24 hours post Remimazolam infusion).
|
3 days
|
Pharmacodynamics Remimazolam and its metabolites (CNS 7054): steady state plasma levels and elimination.
Time Frame: 3 days
|
measured during the infusion and at the end.
9 Pharmacodynamics blood samplings during the infusion, and at Day-3, after Remimazolam discontinuation.
In total 9 (nine) blood samples of 2 ml will be collected during the 48-hour infusion and during elimination phase (up to 24 hours post Remimazolam infusion).
|
3 days
|
Laboratory parameters : blood gas
Time Frame: 4 days
|
Routine laboratory tests for blood gas will be made within this time frame: from day0 to day3.
|
4 days
|
Laboratory parameters: haemoglobin
Time Frame: 4 days
|
Routine laboratory tests for haemoglobin will be made within this time frame: from day0 to day3.
|
4 days
|
Laboratory parameters: platelet count
Time Frame: 4 days
|
Routine laboratory tests for platelet count will be made within this time frame: from day0 to day3.
|
4 days
|
Laboratory parameters: white blood cell count
Time Frame: 4 days
|
Routine laboratory tests for white blood cell count will be made within this time frame: from day0 to day3.
|
4 days
|
Laboratory parameters: ionogram
Time Frame: 4 days
|
Routine laboratory tests for ionogram will be made within this time frame: from day0 to day3.
|
4 days
|
Laboratory parameters: creatinine
Time Frame: 4 days
|
Routine laboratory tests for creatinine will be made within this time frame: from day0 to day3.
|
4 days
|
Laboratory parameters: bilirubin
Time Frame: 4 days
|
Routine laboratory tests for bilirubin will be made within this time frame: from day0 to day3.
|
4 days
|
Laboratory parameters: albumin
Time Frame: 4 days
|
Routine laboratory tests for albumin will be made within this time frame: from day0 to day3.
|
4 days
|
Laboratory parameters: liver enzymes
Time Frame: 4 days
|
Routine laboratory tests for liver enzymes will be made within this time frame: from day0 to day3.
|
4 days
|
Laboratory parameters: phosphorus
Time Frame: 4 days
|
Routine laboratory tests for phosphorus will be made within this time frame: from day0 to day3.
|
4 days
|
Laboratory parameters: magnesium
Time Frame: 4 days
|
Routine laboratory tests for magnesium will be made within this time frame: from day0 to day3.
|
4 days
|
Extubation failure defined as the need to intubate a patient in the 96 hours following extubation.
Time Frame: 28 days
|
Extubation failure will be defined as the need to intubate a patient in the 96 hours following extubation.
|
28 days
|
Length of Mechanical ventilation.
Time Frame: 28 days
|
Defined as the duration between the initiation and the successful weaning of mechanical ventilation.
From Day-1 to ICU discharge or Day-28
|
28 days
|
Death.
Time Frame: 28 days
|
in the ICU or at Day-28 if the patient is not discharged
|
28 days
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Raphaël CINOTTI, MD, CHU de Nantes
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- RC20_0319
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Stroke
-
University Hospital, GhentRecruitingStroke | Stroke, Ischemic | Stroke, Acute | Stroke Sequelae | Stroke HemorrhagicBelgium
-
Moleac Pte Ltd.RecruitingStroke | Stroke, Ischemic | Stroke Sequelae | Stroke, Cardiovascular | Strokes Thrombotic | Stroke, Embolic | Stroke, CryptogenicSingapore, Philippines
-
Moleac Pte Ltd.Not yet recruitingStroke | Stroke, Ischemic | Stroke Sequelae | Stroke, Cardiovascular | Strokes Thrombotic | Stroke, Embolic | Stroke, Cryptogenic
-
IRCCS San Camillo, Venezia, ItalyRecruitingStroke | Stroke, Ischemic | Stroke Sequelae | Stroke HemorrhagicItaly
-
Vanderbilt University Medical CenterPatient-Centered Outcomes Research Institute; University of Alabama at BirminghamEnrolling by invitationStroke | Stroke, Ischemic | Stroke, Acute | Stroke Sequelae | Engagement, Patient | Stroke HemorrhagicUnited States
-
University of MinnesotaAmerican Occupational Therapy FoundationRecruitingStroke | Stroke Sequelae | Stroke Hemorrhagic | Stroke IschemicUnited States
-
University of British ColumbiaCanadian Institutes of Health Research (CIHR); Michael Smith Foundation for...RecruitingStroke | Stroke, Ischemic | Stroke Hemorrhagic | Chronic StrokeCanada
-
University of CincinnatiMedical University of South Carolina; University of California, Los Angeles; University...RecruitingStroke | Stroke, Ischemic | Stroke, Acute | Stroke HemorrhagicUnited States
-
University of LiegeCompletedStroke, Acute | Stroke Hemorrhagic | Stroke, ComplicationBelgium
-
Turkish Stroke Research and Clinical Trials NetworkElectroCore INC; Turkish Neurological SocietyCompletedStroke | Stroke, Ischemic | Stroke, Acute | Stroke, HemorrhagicTurkey
Clinical Trials on Remimazolam
-
Konkuk University Medical CenterNot yet recruiting
-
Acacia Pharma LtdPaion UK Ltd.Active, not recruitingPediatric ALLUnited States, Denmark
-
Paion UK Ltd.PRA Health SciencesCompleted
-
Tongji HospitalRecruitingBidirectional EndoscopyChina
-
Jiangsu HengRui Medicine Co., Ltd.Recruiting
-
Jiangsu HengRui Medicine Co., Ltd.CompletedSedation in the Upper Gastrointestinal EndoscopyChina
-
Tongji HospitalRecruitingEffect of DrugChina
-
Kangbuk Samsung HospitalNot yet recruitingHypotension on Induction
-
Wuhan Union Hospital, ChinaYichang Humanwell Pharmaceutical Co., Ltd., ChinaRecruitingMechanically Ventilated PatientsChina