Lorazepam Sedation for Critically Ill Children

NCT ID: NCT00109395

Last Updated: 2023-03-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

179 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-09-30

Study Completion Date

2007-09-30

Brief Summary

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This clinical trial is being performed under the Best Pharmaceuticals for Children Act, signed into law in 2002 in order to improve pediatric labeling for off-patent drugs. The purpose of this study is to make sure that lorazepam, when given to children who are very sick in the Intensive Care Unit and who are on a breathing machine, is safe and works as well as a drug called midazolam. Midazolam is already approved by the FDA for this use, but lorazepam is not, even though both drugs are commonly used for sedation.

Detailed Description

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Lorazepam is used clinically for sedation of mechanically ventilated children, but has not been approved by the FDA for this indication in children. The purpose of this study, in response to the Written Request by FDA, is to determine the safety, efficacy, and dosage required for lorazepam compared with midazolam, which is approved by FDA for children for this indication.

Study participants must be children who are critically ill and receiving mechanical ventilation who require sedation. Participants will be randomized to lorazepam (intermittent bolus or continuous infusion) or midazolam (continuous infusion). Sedation will be monitored using the COMFORT score. Blood will be drawn to measure lorazepam/midazolam plasma concentrations, and to measure the plasma concentrations of excipients (benzyl alcohol and glycols) in patients receiving lorazepam.

Conditions

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Critical Illness

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Lorazepam Intermittent bolus

lorazepam administered by intermittent bolus

Group Type ACTIVE_COMPARATOR

Lorazepam

Intervention Type DRUG

Intravenous dosage forms, administered at dose and frequency per protocol in order to achieve adequate sedation as measured by the Comfort score

lorazepam continuous infusion

lorazepam administered by continuous infusion

Group Type ACTIVE_COMPARATOR

Lorazepam CI

Intervention Type DRUG

Intravenous dosage forms, administered at dose and frequency per protocol in order to achieve adequate sedation as measured by the Comfort score

midazolam continous infusion

midazolam administered by continous infusion

Group Type ACTIVE_COMPARATOR

Midazolam

Intervention Type DRUG

Intravenous dosage forms, administered at dose and frequency per protocol in order to achieve adequate sedation as measured by the Comfort score

Interventions

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Lorazepam

Intravenous dosage forms, administered at dose and frequency per protocol in order to achieve adequate sedation as measured by the Comfort score

Intervention Type DRUG

Midazolam

Intravenous dosage forms, administered at dose and frequency per protocol in order to achieve adequate sedation as measured by the Comfort score

Intervention Type DRUG

Lorazepam CI

Intravenous dosage forms, administered at dose and frequency per protocol in order to achieve adequate sedation as measured by the Comfort score

Intervention Type DRUG

Other Intervention Names

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Ativan Versed Ativan

Eligibility Criteria

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Inclusion Criteria

* Males or females from full term birth (at least 38 weeks post conceptual age) through 18 years
* Patients must be intubated and mechanically ventilated in the PICU less than or equal to 24 hr
* Patients in whom the use of neuromuscular blocking agents would normally NOT be expected to be used.
* Patient's parent or guardian has signed a consent form prior to initiation of study procedures
* Patients with cardiac, renal, or hepatic dysfunction will be actively sought

Exclusion Criteria

* Life expectancy \< 48 hr
* Expected duration of sedation \< 48 hr
* Patient with history of hypersensitivity to any component of lorazepam, midazolam, fentanyl, thiopental
* Females pregnant or breast feeding
* Patient requires sedatives or analgesics other than study drug
Minimum Eligible Age

1 Day

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Case Western Reserve University

OTHER

Sponsor Role collaborator

The Emmes Company, LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jeffrey L Blumer, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Case Western Reserve University

Locations

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Case Western Reserve University

Cleveland, Ohio, United States

Site Status

Countries

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United States

Other Identifiers

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HHSN275200403367C (contract)

Identifier Type: -

Identifier Source: org_study_id

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