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Die Coffein, Postoperative Delirium, and Change in Outcomes After Surgery (CAPACHINOS-2)-Studie

5. November 2026 aktualisiert von: Phillip Vlisides, University of Michigan

The objective of this study is to test the effects of caffeine on neurocognitive and clinical recovery after major surgery. Specifically, this trial tests the primary hypothesis that caffeine will reduce the incidence of postoperative delirium.

Studienübersicht

Status

Abgeschlossen

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Delirium is a syndrome characterized by failure of basic cognitive functions that affects approximately 20-50% of older surgical patients. Delirium during surgical recovery is associated with increased mortality, cognitive and functional decline, and prolonged hospitalization. In fact, 3-year survival rates for acutely hospitalized patients with delirium, and subsyndromal delirium, are both less than 50%. Older age is predictive of delirium after surgery, and with aging surgical populations, the incidence of postoperative delirium and related complications are likely to increase in the coming years.

Caffeine represents a novel, neurobiologically informed candidate intervention for reducing risk of early postoperative delirium. Caffeine promotes arousal via adenosine receptor antagonism and improves cognitive function concurrent with increased cortical cholinergic tone. Our preliminary data suggest that caffeine reduces risk of postanesthesia care unit (PACU) delirium in adult non-cardiac surgery patients by optimizing cortical dynamics for cognition. Caffeine also optimizes key neurocognitive processes that support information processing and may improve other, related aspects of clinical recovery, such as rebound headache in habitual caffeine users. The objective of this trial is to thus test the effects of caffeine on neurocognitive and clinical recovery after major surgery. Specifically, the primary hypothesis is that caffeine will reduce the incidence of postoperative delirium. The secondary objectives are to (1) test whether caffeine positively impacts the quality of postoperative recovery via validated patient-reported measures and (2) identify neural correlates of delirium and Mild Cognitive Impairment via advanced electroencephalographic (EEG) analysis.

Studientyp

Interventionell

Einschreibung (Tatsächlich)

250

Phase

  • Phase 2

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

    • Michigan
      • Ann Arbor, Michigan, Vereinigte Staaten, 48109
        • Michigan Medicine

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

70 Jahre und älter (Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  1. Adult (>/= 70 years old) undergoing non-cardiac, non-intracranial neurologic, non-major vascular surgery requiring general anesthesia with a planned admission for at least 48 hours.
  2. Stated willingness to comply with all study procedures and availability for the duration of the study.
  3. Provision of signed and dated informed consent form.

Exclusion Criteria:

  1. Emergency surgery
  2. Outpatient surgery
  3. Severe cognitive impairment precluding the capacity for informed consent
  4. Seizure disorder history
  5. Intolerance or allergy to caffeine (based on subjective reporting or objective documentation)
  6. Weight >130 kg (as a 3 mg/kg dose would approach the upper limit of daily intake recommended by the FDA)
  7. Enrollment in conflicting research study
  8. Patients in acute liver failure
  9. Acute kidney injury preoperatively
  10. Diagnosis of pheochromocytoma
  11. Active carcinoid syndrome
  12. Severe audiovisual impairment
  13. Non-English speaking

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Vervierfachen

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Placebo-Komparator: Control

Prepared intravenous piggyback solution of 5 percent dextrose water at multiple postoperative time points over a 30-minute infusion period.

Dextrose 5% in water

Experimental: Low-dose Caffeine

Prepared intravenous low-dose caffeine citrate (1.5 mg/kg) at multiple postoperative time points over a 30-minute infusion period.

Low-dose caffeine citrate (1.5 mg/kg)

High-dose Caffeine citrate (3 mg/kg)

Experimental: High-dose Caffeine

Prepared intravenous high-dose caffeine citrate (3 mg/kg) at multiple postoperative time points over a 30-minute infusion period.

Low-dose caffeine citrate (1.5 mg/kg)

High-dose Caffeine citrate (3 mg/kg)

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Delirium
Zeitfenster: Day of surgery through afternoon of postoperative day three

Any positive delirium screen (yes/no) as determined by the long-form Confusion Assessment Method (CAM), and supplemented by a validated daily chart review method.

Day of surgery through afternoon of postoperative day three

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Delirium Severity
Zeitfenster: Day of surgery through afternoon of postoperative day three

For all participants screened for delirium, the associated severity score will be recorded using the Confusion Assessment Method Long Form Severity Score (CAM-S) (n, 0-19, with higher number indicating more severe delirium)

Day of surgery through afternoon of postoperative day three
Delirium Duration
Zeitfenster: Day of surgery through afternoon of postoperative day three

The cumulative number of days (n) with a positive delirium screen will be calculated for all participants

Day of surgery through afternoon of postoperative day three
Patient-Reported Quality of Recovery
Zeitfenster: Preoperative baseline through postoperative day three afternoon

Assessed via the 15-item Quality of Recovery Score (n, 0-150, with higher number indicating better quality of recovery from the patient perspective)

Preoperative baseline through postoperative day three afternoon
Sedation
Zeitfenster: Preoperative baseline through postoperative day three afternoon

Any positive screen based on the Richmond Agitation Sedation Scale (RASS; n, -5 to +4). Scores from -5 to -2 will count as a positive screen for sedation.

Preoperative baseline through postoperative day three afternoon
Agitation
Zeitfenster: Preoperative baseline through postoperative day three afternoon

Any positive screen based on the Richmond Agitation Sedation Scale (RASS; n, -5 to +4). Scores from +2 to +4 will count as a positive screen for agitation

Preoperative baseline through postoperative day three afternoon
Headache
Zeitfenster: Preoperative baseline through postoperative day three afternoon

Headache severity will be assessed via 10-centimeter visual analog scale (0-100 mm, with higher score indicating more severe headache)

Preoperative baseline through postoperative day three afternoon
Cumulative Opioid Consumption
Zeitfenster: Day of surgery through postoperative day three afternoon

Postoperative opioid consumption, oral morphine equivalents (mg)

Day of surgery through postoperative day three afternoon

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Anesthetic Emergence
Zeitfenster: Duration of time from surgical dressing completion to anesthetic emergence (min); generally expected to be between 10 and 60 minutes

Time (minutes) from surgical closure to extubation

Duration of time from surgical dressing completion to anesthetic emergence (min); generally expected to be between 10 and 60 minutes
Pulmonary Complications
Zeitfenster: From extubation until end of postanesthesia care unit stay

Composite outcome (yes/no) of any of the following: airway adjunct use, unplanned continuous positive airway pressure device, unplanned humidified high-flow oxygen, need for bag-mask ventilation, or reintubation

From extubation until end of postanesthesia care unit stay
Hospital Length of Stay
Zeitfenster: Morning of surgery until day of hospital discharge, up to 30 days

Total number of days (n) spent in the hospital, up to 30 days

Morning of surgery until day of hospital discharge, up to 30 days
Discharge Disposition
Zeitfenster: Day of hospital discharge, up to 30 days

Proportion of patients in each group (%) discharged somewhere other than home (e.g., Long-Term Care Facility), up to 30 days

Day of hospital discharge, up to 30 days
30-Day Cognitive Function
Zeitfenster: 30 days after hospital discharge

Cognitive function score based on the Montreal Cognitive Assessment (n, 0-30, with higher scores reflecting higher cognitive function)

30 days after hospital discharge
30-Day Physical Function
Zeitfenster: 30 days after hospital discharge

Physical function score based on the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function 10a score (n, 10-50, with higher score indicating better physical function)

30 days after hospital discharge

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Mitarbeiter

Ermittler

  • Hauptermittler: Phillip Vlisides, MD, Assistant Professor of Anesthesiology

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

20. Februar 2023

Primärer Abschluss (Tatsächlich)

16. April 2026

Studienabschluss (Tatsächlich)

20. Mai 2026

Studienanmeldedaten

Zuerst eingereicht

6. Oktober 2022

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

6. Oktober 2022

Zuerst gepostet (Tatsächlich)

10. Oktober 2022

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

10. November 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

5. November 2026

Zuletzt verifiziert

1. Juli 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • HUM00218290
  • R01AG075005 (US NIH Stipendium/Vertrag)

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

Clinical and electroencephalographic data will be preserved and made available for sharing. Data will be saved in various formats, such as comma-separated values (CSV), open document format (ODF), and European Data Format (EDF) for waveform data. Software programs designed to accommodate electroencephalographic waveform data (e.g., MATLAB) will be required for data access and analysis. Specific software and coding recommendations can be made available upon data sharing request.

Any data not permitted to be shared, as specified in written informed consent documents, will be withheld. Likewise, no data will be shared that may compromise the safety or privacy of participants, and no data will be shared that would violate local, state, or federal laws or policies (including the Health Insurance Portability and Accountability Act). All data will be de-identified.

IPD-Sharing-Zeitrahmen

Scientific data will be made available after primary trial manuscripts (for both clinical and electroencephalographic data) are accepted for publication. Data will be made available for as long as possible in compliance with National Institutes of Health and University of Michigan policies.

IPD-Sharing-Zugriffskriterien

Data will be shared upon execution of Data Use Agreements in compliance with University of Michigan policies and procedures. Interested researchers will need to contact the study PI (Dr. Vlisides) for obtaining data via Data Use Agreement. All data will be shared upon reasonable request after primary trial manuscripts are published.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL
  • SAFT
  • ICF

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Ja

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Produkt, das in den USA hergestellt und aus den USA exportiert wird

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .