- ICH GCP
- Register voor klinische proeven in de VS.
- Klinische proef NCT02426320
Pilot Study for Sedation Interruption in Children
Daily Interruption of Sedative Infusions in Mechanically Ventilated Children: A Randomized Pilot Study
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
This is a prospective single-center, superiority, open randomized controlled trial comparing sedation interruption protocol and routine continuous sedation in mechanically ventilation (MV) children.
The study will be conducted in the twelve beds Pediatric Intensive Care Unit (PICU) at the Montreal Children's Hospital, a pediatric tertiary care and teaching hospital.
Patients will be enrolled prospectively within 24 hours of intubation and MV. After obtaining written consent patients will then be randomized to interrupted sedation or standard sedation protocol. The investigators will randomize using a computer-generated sequence of random numbers.
A Sedation protocol will be used for both groups to adjust continuous infusions of sedatives/analgesics to a targeted Comfort-Behavior scale. In the intervention group, sedation infusions will be interrupted daily at 8:00 AM, this interruption will be continued until the patient is under-sedated according to the Comfort Behavior scale goals or in the presence of symptoms of hemodynamic instability or respiratory distress. Then the patient will receive a bolus of sedation and the infusion will be restarted at a dose 50% less than the previous dose to return to the Comfort Score goal.
Studietype
Inschrijving (Verwacht)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
-
-
Quebec
-
Montreal, Quebec, Canada, H3H 1P3
- Werving
- Montreal Children's Hospital
-
-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Intubated and mechanically ventilated patients due to respiratory failure of multiple etiologies or after major surgical procedures for more than 24 hours.
- Sedation managed by benzodiazepines and opioids infusions
Exclusion Criteria:
- If sedation is required as part of medical management (Pulmonary hypertension, Increase intracranial pressure, Seizures
- Trauma & burn admissions
- Patients resuscitated from cardiac arrest
- Allergy to sedation (midazolam)
- Allergy to analgesia (fentanyl, morphine)
- Difficult airway including post-operative airway surgeries. (As deemed by ICU physician in charge)
- High frequency oscillator
- Special gas as inhaled nitric oxide, or isoflurane.
- Chronic ventilatory support
- Neuromuscular diseases
- Corrected Gestational age less than 37 weeks.
- Patients not expected to survive to discharge as per attending physician.
- Palliative care patients.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ondersteunende zorg
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Actieve vergelijker: Sedation Interruption Protocol + standard sedation protocol
Nurse directed protocols for administering sedation and/or analgesia, with daily interruption of sedation/analgesia
|
|
|
Actieve vergelijker: Standard sedation protocol
Nurse directed protocol for administering sedation and/or analgesia.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Recruitment rate
Tijdsspanne: At 30 days
|
The number of eligible patients who provided informed consent to participate in the study divided by the total number of eligible patients who were asked for informed consent during the pilot study period over 1 year period.
|
At 30 days
|
|
Adherence Rate
Tijdsspanne: At 30 days
|
At 30 days
|
|
|
Reasons for non-participation
Tijdsspanne: At 30 days
|
At 30 days
|
|
|
Duration of mechanical ventilation in hours.
Tijdsspanne: intraoperative
|
Total number of hours between the moment patient was intubated to the moment of extubation.
|
intraoperative
|
Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Conall Francoeur, McGill University Health Centre/Research Institute of the McGill University Health Centre
- Hoofdonderzoeker: Christina Maratta, McGill University Health Centre/Research Institute of the McGill University Health Centre
- Hoofdonderzoeker: Maryse Dagenais, McGill University Health Centre/Research Institute of the McGill University Health Centre
Publicaties en nuttige links
Algemene publicaties
- Girard TD, Kress JP, Fuchs BD, Thomason JW, Schweickert WD, Pun BT, Taichman DB, Dunn JG, Pohlman AS, Kinniry PA, Jackson JC, Canonico AE, Light RW, Shintani AK, Thompson JL, Gordon SM, Hall JB, Dittus RS, Bernard GR, Ely EW. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet. 2008 Jan 12;371(9607):126-34. doi: 10.1016/S0140-6736(08)60105-1.
- Kress JP, Pohlman AS, O'Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med. 2000 May 18;342(20):1471-7. doi: 10.1056/NEJM200005183422002.
- Schweickert WD, Gehlbach BK, Pohlman AS, Hall JB, Kress JP. Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients. Crit Care Med. 2004 Jun;32(6):1272-6. doi: 10.1097/01.ccm.0000127263.54807.79.
- Anifantaki S, Prinianakis G, Vitsaksaki E, Katsouli V, Mari S, Symianakis A, Tassouli G, Tsaka E, Georgopoulos D. Daily interruption of sedative infusions in an adult medical-surgical intensive care unit: randomized controlled trial. J Adv Nurs. 2009 May;65(5):1054-60. doi: 10.1111/j.1365-2648.2009.04967.x.
- Mehta S, Burry L, Cook D, Fergusson D, Steinberg M, Granton J, Herridge M, Ferguson N, Devlin J, Tanios M, Dodek P, Fowler R, Burns K, Jacka M, Olafson K, Skrobik Y, Hebert P, Sabri E, Meade M; SLEAP Investigators; Canadian Critical Care Trials Group. Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: a randomized controlled trial. JAMA. 2012 Nov 21;308(19):1985-92. doi: 10.1001/jama.2012.13872. Erratum In: JAMA. 2013 Jan 16;309(3):237.
- Gupta K, Gupta VK, Jayashree M, Singhi S. Randomized controlled trial of interrupted versus continuous sedative infusions in ventilated children. Pediatr Crit Care Med. 2012 Mar;13(2):131-5. doi: 10.1097/PCC.0b013e31820aba48. Erratum In: Pediatr Crit Care Med. 2012 May;13(3):373. Muralindharan, Jayashree [corrected to Jayashree, Muralindharan].
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Verwacht)
Studie voltooiing (Verwacht)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Andere studie-ID-nummers
- 14-011-PED
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .
Klinische onderzoeken op Sedation Interruption Protocol
-
Istanbul Medeniyet UniversityOnbekend
-
GE HealthcareVoltooid
-
Capital Medical UniversityVoltooidIntensive Care-afdelingChina
-
Assistance Publique - Hôpitaux de ParisNog niet aan het werven
-
Ciclo de MutaçãoSao Jose do Rio Preto Medical SchoolVoltooid
-
Huazhong University of Science and TechnologyWuhan Union Hospital, China; Wuhan No.1 Hospital; The Affiliated Hospital of Jiangxi... en andere medewerkersWervingVerminderde ovariële reserveChina
-
Indonesia UniversityVoltooidGespleten gehemelte | Fistel van zacht gehemelte (aandoening) | Maxillaire hypoplasieIndonesië
-
Central Hospital, Nancy, FranceOnbekendKruisbandletsel | EvenwichtscontroleFrankrijk
-
Loma Linda UniversityVoltooidHemiplegie en/of hemiparese na een beroerteVerenigde Staten
-
IRCCS San RaffaeleActief, niet wervend