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Pharmacoeconomic Consequences Of Analgesia in the Intensive Care Unit (ICU)

25. maj 2017 opdateret af: GlaxoSmithKline

A Randomized, Open Label, Multicentre Study to Compare the Pharmaco-economic Implications of an Analgesia Based Regimen With Remifentanil and a Conventional Sedation Based Regimen Using Propofol in Medical and Post-surgical ICU Subjects Requiring Mechanical Ventilation for at Least 2 Days.

This study will be a multicentre randomized, open-label, phase IIIb study. This study will evaluate two different techniques of sedation: an analgesia based regimen with remifentanil versus a conventional sedation based regimen using propofol in subjects that require mechanical ventilation for at least 2 days in the ICU. The conventional sedation based regimen will consist of propofol combined with an opioid according to routine clinical practice (morphine, fentanyl, sufentanil or other as required) . The analgesia based regimen will consist of remifentanil, with propofol added on if required.

Studieoversigt

Status

Afsluttet

Betingelser

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

39

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Calabria
      • Catanzaro, Calabria, Italien, 88100
        • GSK Investigational Site
    • Campania
      • Napoli, Campania, Italien, 80131
        • GSK Investigational Site
    • Emilia-Romagna
      • Ferrara, Emilia-Romagna, Italien, 44100
        • GSK Investigational Site
    • Friuli-Venezia-Giulia
      • Udine, Friuli-Venezia-Giulia, Italien, 33100
        • GSK Investigational Site
    • Lazio
      • Roma, Lazio, Italien, 00161
        • GSK Investigational Site
    • Sicilia
      • Palermo, Sicilia, Italien, 90127
        • GSK Investigational Site

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Medical and post-surgical patients admitted to ICU and requiring mechanical ventilation.
  • Intubated subjects expected to require mechanical ventilation for longer than 48 hours after starting the study drug.
  • Subjects requiring both analgesia and sedation with a regimen comprising a hypnotic agent and an opioid.

Exclusion Criteria:

  • Diagnosis: cardiopulmonary resuscitation (CPR) in the previous 24 hours or expecting to require major surgery within the next three days
  • Subject who, in the judgement of the investigator, has a life expectancy of 2 days or refrained or refuses full life support, which would limit the care provided
  • Concurrent medications:

    • Requires or is likely to require neuromuscular blocking agents by continuous infusion to facilitate mechanical ventilation
    • Has or is likely to receive an epidural block during the treatment period

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Propofol
Propofol infusion
conventional sedation in medical and post-surgical Intensive Care Unit subjects requiring mechanical
Eksperimentel: Remifentanil
remifentanil
analgesia in medical and post-surgical Intensive Care Unit subjects requiring mechanical ventilation

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Duration of Time on Mechanical Ventilation (Intent-to-Treat Population)
Tidsramme: Up to 38 days (912 hours)
Time from start of mechanical ventilation until actual extubation (the process of removing a tube from the airway).
Up to 38 days (912 hours)
Duration of Time on Mechanical Ventilation (Modified-Intent-to-Treat Population)
Tidsramme: Up to 38 days (912 hours)
Time from start of mechanical ventilation until actual extubation.
Up to 38 days (912 hours)
Duration of Time on Mechanical Ventilation (Per-Protocol Population)
Tidsramme: Up to 38 days (912 hours)
Time from start of mechanical ventilation until actual extubation
Up to 38 days (912 hours)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Duration of Time in Intensive Care Unit (ICU) and Potential Stay in ICU (the Time Expected for Extubation, i.e., the Time Between Intubation and Eligibility for Extubation, According to Investigator's Decision)
Tidsramme: Up to 38 days (912 hours)
Duration of Intensive Care Unit (ICU) stay and the duration of potential stay in the ICU were measured.
Up to 38 days (912 hours)
Duration of Extubation
Tidsramme: up to 38 days (912 hours)
Duration of extubation was measured.
up to 38 days (912 hours)
Duration of Weaning
Tidsramme: up to 38 days (912 hours)
Duration of weaning (the time from the intubation until the recovery of natural respiratory ability) was measured.
up to 38 days (912 hours)
Duration of Remifentanil Infusion (ITT Population)
Tidsramme: Up to 10 days (240 hours)
Data for this measure come from the infusion pump display; the infusion pump infuses medication (analgesics and sedative agents) into the participant's circulatory system.
Up to 10 days (240 hours)
Duration of Propofol Infusion (ITT Population)
Tidsramme: up to 10 days (240 hours)
Data for this measure come from the infusion pump display; the infusion pump infuses medication (analgesics and sedative agents) into the participant's circulatory system.
up to 10 days (240 hours)
Duration of Sufentanil, Fentanil, and Morphine Infusion (ITT Population)
Tidsramme: up to 10 days (240 hours)
Data for this measure come from the infusion pump display; the infusion pump infuses medication (analgesics and sedative agents) into the participant's circulatory system.
up to 10 days (240 hours)
Dose of Remifentanil Administered - Continuous Infusion
Tidsramme: Up to 10 days
Data for this measure come from infusion pump display; the infusion pump infuses medication (analgesics and sedative agents) into the participant's circulatory system.
Up to 10 days
Doses of Sufentanil and Fentanil Administered - Continuous Infusion
Tidsramme: up to 10 days
Data for this measure come from infusion pump display; the infusion pump infuses medication (analgesics and sedative agents) into the participant's circulatory system.
up to 10 days
Dose of Propofol Administered - Continuous Infusion
Tidsramme: Up to 10 days
Data for this measure come from infusion pump display; the infusion pump infuses medication (analgesics and sedative agents) into the participant's circulatory system.
Up to 10 days
Dose of Morphine Administered - Continuous Infusion
Tidsramme: up to 10 days
Data for this measure come from infusion pump display; the infusion pump infuses medication (analgesics and sedative agents) into the participant's circulatory system.
up to 10 days
Total Dose of Propofol Administered - Bolus
Tidsramme: Up to 10 days
Data from this measure come from infusion pump display; the infusion pump infuses medication (analgesics and sedative agents) into the participant's circulatory system.
Up to 10 days
Total Dose of Fentanil Administered - Bolus
Tidsramme: Up to 10 days
Data for this measure come from infusion pump display; the infusion pump infuses medication (analgesics and sedative agents) into the participant's circulatory system.
Up to 10 days
Number of Participants Analyzed for Sedation - Agitation Scale (SAS) and Pain Intensity (PI) Scale
Tidsramme: Up to 38 Days
Data from participants in the study for which the Sedation-Agitation Scale (SAS) and Pain Intensity (PI) were recorded were analyzed. "Sedation - Agitation" was assessed, using the "Riker Sedation-Agitation Scale" (SAS), by the following 7-point scale: 7, dangerous agitation; 6, very agitated; 5, agitated; 4, calm, cooperative; 3, sedated; 2, very sedated; 1, unarousable. "Pain Intensity" was assessed by the following 6-point Pain Intensity Scale: 1, no pain; 2, mild pain; 3, moderate pain; 4, severe pain; 5 very severe pain; 6, worst possible pain.
Up to 38 Days
Sedation-Agitation From Screening Through the End of Study
Tidsramme: Up to 38 days
"Sedation - Agitation" was assessed, using the "Riker Sedation-Agitation Scale" (SAS), by the following 7-point scale: 7, dangerous agitation; 6, very agitated; 5, agitated; 4, calm, cooperative; 3, sedated; 2, very sedated; 1, unarousable.
Up to 38 days
Sedation-Agitation for Day 7
Tidsramme: Day 7
"Sedation - Agitation" was assessed, using the "Riker Sedation-Agitation Scale" (SAS), by the following 7-point scale: 7, dangerous agitation; 6, very agitated; 5, agitated; 4, calm, cooperative; 3, sedated; 2, very sedated; 1, unarousable.
Day 7
Sedation-Agitation From Day 8 to Day 10
Tidsramme: Days 8, 9, and 10
"Sedation - Agitation" was assessed, using the "Riker Sedation-Agitation Scale" (SAS), by the following 7-point scale: 7, dangerous agitation; 6, very agitated; 5, agitated; 4, calm, cooperative; 3, sedated; 2, very sedated; 1, unarousable.
Days 8, 9, and 10
Number of Participants Analyzed for BIS (Bispectral Index Scale)
Tidsramme: Up to 38 days
Participants in the study for which BIS were evaluated. The BIS monitor provides a single dimensionless number, the BIS value, which ranges from 0 to 100. A BIS value of 0 equals electroencephalogram silence, near 100 is the expected value in a fully awake adult, and between 40 and 60 indicates a level for general anaesthesia.
Up to 38 days
Bispectral Index (BIS)
Tidsramme: Screening through End of Study, up to 38 days
The BIS monitor provides a single dimensionless number, the BIS value, which ranges from 0 to 100. A BIS value of 0 equals electroencephalogram silence, near 100 is the expected value in a fully awake adult, and between 40 and 60 indicates a level for general anaesthesia.
Screening through End of Study, up to 38 days
Bispectral Index (BIS) for Day 5
Tidsramme: Day 5
The BIS monitor provides a single dimensionless number, the BIS value, which ranges from 0 to 100. A BIS value of 0 equals electroencephalogram silence, near 100 is the expected value in a fully awake adult, and between 40 and 60 indicates a level for general anaesthesia.
Day 5
Bispectral Index (BIS) for Extubation Period and Post-Extubation Period
Tidsramme: up to 38 days
The BIS monitor provides a single dimensionless number, the BIS value, which ranges from 0 to 100. A BIS value of 0 equals electroencephalogram silence, near 100 is the expected value in a fully awake adult, and between 40 and 60 indicates a level for general anaesthesia.
up to 38 days
Pain Intensity (PI)
Tidsramme: Up to 38 days
"Pain Intensity" was assessed by the following 6-point Pain Intensity Scale: 1, no pain; 2, mild pain; 3, moderate pain; 4, severe pain; 5 very severe pain; 6, worst possible pain.
Up to 38 days
Pain Intensity From Day 8 to Day 10
Tidsramme: Days 8, 9, and 10
"Pain Intensity" was assessed by the following 6-point Pain Intensity Scale: 1, no pain; 2, mild pain; 3, moderate pain; 4, severe pain; 5 very severe pain; 6, worst possible pain.
Days 8, 9, and 10

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. november 2007

Primær færdiggørelse (Faktiske)

1. august 2008

Studieafslutning (Faktiske)

1. september 2008

Datoer for studieregistrering

Først indsendt

15. februar 2007

Først indsendt, der opfyldte QC-kriterier

15. februar 2007

Først opslået (Skøn)

19. februar 2007

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

30. maj 2017

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. maj 2017

Sidst verificeret

1. maj 2017

Mere information

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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