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

25 mai 2017 mis à jour par: 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.

Aperçu de l'étude

Statut

Résilié

Les conditions

Type d'étude

Interventionnel

Inscription (Réel)

39

Phase

  • Phase 3

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

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

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

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

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Comparateur actif: Propofol
Perfusion de propofol
conventional sedation in medical and post-surgical Intensive Care Unit subjects requiring mechanical
Expérimental: Remifentanil
remifentanil
analgesia in medical and post-surgical Intensive Care Unit subjects requiring mechanical ventilation

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Duration of Time on Mechanical Ventilation (Intent-to-Treat Population)
Délai: 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)
Délai: 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)
Délai: Up to 38 days (912 hours)
Time from start of mechanical ventilation until actual extubation
Up to 38 days (912 hours)

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
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)
Délai: 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
Délai: up to 38 days (912 hours)
Duration of extubation was measured.
up to 38 days (912 hours)
Duration of Weaning
Délai: 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)
Délai: 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)
Délai: 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)
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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)
Délai: 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)
Délai: 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
Délai: 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
Délai: 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)
Délai: 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
Délai: 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

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 novembre 2007

Achèvement primaire (Réel)

1 août 2008

Achèvement de l'étude (Réel)

1 septembre 2008

Dates d'inscription aux études

Première soumission

15 février 2007

Première soumission répondant aux critères de contrôle qualité

15 février 2007

Première publication (Estimation)

19 février 2007

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

30 mai 2017

Dernière mise à jour soumise répondant aux critères de contrôle qualité

25 mai 2017

Dernière vérification

1 mai 2017

Plus d'information

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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