Dexmedetomidinine in the Prevention of Postoperative Delirium in the Intensive Care Unit After Cardiac Surgery

NCT ID: NCT05849597

Last Updated: 2024-12-04

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-03-01

Study Completion Date

2025-06-30

Brief Summary

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This is a prospective, randomized, single blinded, controlled clinical trial designed to compare the clinical effects of sedation with dexmedetomidine versus propofol in patients undergoing cardiac surgery.

Detailed Description

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The study will include adult patients of both sexes scheduled for elective cardiac surgery with the use of cardiopulmonary bypass (including coronary artery bypass grafting, valve repair/replacement, and combined).

The patients included in the study will be randomized in 1:1 ratio using computer generated numbers into two groups. The first group of patients, upon arrival to the intensive care unit will be sedated with continuous dexmedetomidine infusion in doses 0.2-0.7 mcg/kg/h. Dexmedetomidine infusion will be discontinued before weaning from mechanical ventilation and extubation. The second group of patients, upon arrival to the intensive care unit will be sedated with continuous propofol infusion in doses 1-2 mg/kg/h. Propofol infusion will also be discontinued before weaning from mechanical ventilation and extubation.

Sedation level will be assessed using Richmond Agitation and Sedation Scale (RASS) every two hours. Postoperative analgesia will be managed according to protocol (opioid analgesics, non-steroid anti-inflammatory drugs, paracetamol), with pain level assessment using visual analog scale (0 - no pain; 10 - unbearable pain).

The following data will be registered: age, sex, body mass index (BMI), hemoglobin, heart rate, and LVEF. Among the postoperative parameters, the following will registered: duration of mechanical ventilation (in hours), extubation time, ICU and hospital length of stay (in days), postoperative hemoglobin, blood product transfusion rates, occurrence of atrial fibrillation and assessment of delirium. Assessment of delirium will be performed using the confusion assessment method for intensive care unit (CAM-ICU) every 12 hours during five postoperative days.

Conditions

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Intensive Care Unit Delirium

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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Dexmedetomidine

Evaluate the effects of dexmedetomidine for sedation of patients in the intensive care unit after open heart surgery

Group Type EXPERIMENTAL

Dexmedetomidine

Intervention Type DRUG

Upon arrival to the intensive care unit after open heart surgery, the patients will be sedated with continuous dexmedetomidine infusion in doses 0.2-0.7 mcg/kg/h.

Propofol

Compare the clinical outcomes of the experimental group with the standard of care, i.e. sedation with propofol

Group Type ACTIVE_COMPARATOR

Propofol

Intervention Type DRUG

Upon arrival to the intensive care unit after open heart surgery, the patients will be sedated with continuous propofol infusion in doses 1-2 mg/kg/h.

Interventions

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Dexmedetomidine

Upon arrival to the intensive care unit after open heart surgery, the patients will be sedated with continuous dexmedetomidine infusion in doses 0.2-0.7 mcg/kg/h.

Intervention Type DRUG

Propofol

Upon arrival to the intensive care unit after open heart surgery, the patients will be sedated with continuous propofol infusion in doses 1-2 mg/kg/h.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* patients undergoing open heart surgery with the use of cardiopulmonary bypass (including coronary artery bypass grafting, valve repair/replacement, and combined)
* left ventricular ejection fraction (LVEF) \>40%.

Exclusion Criteria

* preoperative atrial fibrillation
* previous history of interventionally treated arrhythmias
* second and third degree atrioventricular block
* bradycardia with heart rate ≤50/min
* pacemaker
* renal or hepatic insufficiency
* emergency procedures
* history of serious mental illness, delirium, and severe dementia
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Novi Sad

OTHER

Sponsor Role lead

Responsible Party

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Mihaela Preveden

Research Assistant

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mihaela Preveden, MD

Role: PRINCIPAL_INVESTIGATOR

Institute of Cardiovascular Diseases of Vojvodina

Locations

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Institute of Cardiovascular Diseases of Vojvodina

Kamenitz, , Serbia

Site Status RECRUITING

Countries

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Serbia

Central Contacts

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Mihaela Preveden, MD

Role: CONTACT

+381214805702

Facility Contacts

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Mihaela Preveden, MD

Role: primary

+381214805702

Other Identifiers

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612-1/1

Identifier Type: -

Identifier Source: org_study_id