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SuspendedNCT03285165DEXSEDATIONUpdated Jul 14, 2020

Cerebral Vascular Effects of Dexmedetomidine Versus Propofol Sedation in Intubated Mechanically Ventilated ICU Patients

A Phase 2/3 interventional study of 0.2-0.7 mcg/kg/h dexmedetomedine infusion. and 10-70 mcg/kg/h propofol infusion. in Sedation, sponsored by Assiut University. Suspended at 1 site in Egypt. Open to participants aged 18 Years to 50 Years. Per ClinicalTrials.gov, last updated 2020-07-14.

Sponsored by Assiut University · Phase 2/3, Interventional, and Treatment

Why this study was suspended
NO AVAILABLE FUND
Phase
Phase 2/3
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
18 Years to 50 Years
Sex
All
01

Study summary

Serial transcranial Doppler (TCD) exams in healthy volunteers and in animal models showed a strong linear relationship between middle cerebral artery (MCA) flow velocity (FV) and dexmedetomidine infusion. The concomitant elevation of pulsatility index (PI) indicates vasoconstriction of the cerebral vasculature as the most profound underlying mechanism.

Read the detailed description

Available clinical evidence on the use of dexmedetomidine sedation in neurosurgical and neurocritical care is limited and no definite conclusion can be drawn. There is a need for The use of dexmedetomidine might be a useful adjunct in clinical situations when the increase in CBF could be detrimental such as vasogenic cerebral edema (i.e., TBI, large brain tumors). However, dexmedetomidine sedation is questionable in patients with subarachnoid hemorrhage and acute stroke, since the associate drop in arterial pressure could worsen the coexisting increase in circulating catecholamines and massive sympathetic outflow. Further high-quality RCTs to evaluate the use of dexmedetomidine as a sedative agent both in general ICU patients and in patients with TBI.

Transcranial Doppler (TCD) is a simple noninvasive bedside tool to assess the cerebral blood flow pattern. The new development of transcranial color Doppler with angle correction option helps to improve the sensitivity of test results. TCD can assess the evolution of CBF alterations and possibly cerebral autoregulation performance and ICP estimation in patients presenting with cerebral pathology.

02

Conditions studied

  • Sedation
03

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adult trauma patients (18-50 years old, ASA I-II).
  • With and without mild TBI.
  • Mild traumatic brain injury will include; brain edema, brain contusion, fracture base, fissure fracture and depressed fracture.
  • The severity of traumatic brain injury will be defined as mild based on basal Glasgow Coma Scale and basal Computerized tomography scanning.
  • Requirements of endotracheal intubation, mechanical ventilation and light to moderate sedation because of associated abdominal or chest traumatic injuries.
  • The sedation needed should of an estimated duration not less than 24h.
  • Baseline hemodynamic parameters within the normal range.
  • Baseline middle cerebral artery flow velocity within the normal range.

Exclusion criteria

Exclusion Criteria:

  • Severe traumatic brain injury, subarachnoid hemorrhage and Intra-cerebral hemorrhage.
  • Spinal cord injury.
  • Hemodynamically unstable patients and patients on inotropes.
  • Patients who have a cardiac pacemaker or automatic implantable cardioverter defibrillator.
  • Patients with hepatic or renal impairment.
  • Pregnant females.
  • Patients who are incarcerated.
04

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
60 participants (estimated)

Study arms

  • Active comparator
    DEX I

    Trauma Patients without TBI received 0.2-0.7 mcg/kg/h dexmedetomedine infusion.

    Drug: 0.2-0.7 mcg/kg/h dexmedetomedine infusion.

  • Active comparator
    DEX II

    Trauma Patients with TBI received 0.2-0.7 mcg/kg/h dexmedetomedine infusion.

    Drug: 0.2-0.7 mcg/kg/h dexmedetomedine infusion.

  • Active comparator
    Propofol I

    Trauma Patients without TBI received 10-70 mcg/kg/h propofol infusion.

    Drug: 10-70 mcg/kg/h propofol infusion.

  • Active comparator
    Propofol II

    Trauma Patients with TBI received 10-70 mcg/kg/h propofol infusion.

    Drug: 10-70 mcg/kg/h propofol infusion.

Interventions

  • Drug0.2-0.7 mcg/kg/h dexmedetomedine infusion.

    patients will receive dexmedetomidine 0.2-0.7 mcg/kg/h infusion for 24h.

    Also known as: Precedex

  • Drug10-70 mcg/kg/h propofol infusion.

    Patients will receive 10-70 mcg/kg/h propofol infusion for 24h.

    Also known as: Deprivan

05

What researchers measure

Primary outcomes

  1. Middle cerebral artery flow velocity

    1. Right and left middle cerebral artery (MCA) will be measured via trans-temporal window and the depth of insinuation will be between 30-60 mm with the subject's head in neutral position. Mean values of simultaneously measured invasive blood pressure recordings and the outer envelope of time averaged MCA flow velocity (FV) recordings during ten consecutive cardiac cycles

    Time frame: 24 hours

06

Study locations

1 site
  • Assiut university main hospital, Trauma ICU
    Assiut, Assiut Governorate 715715, Egypt
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03285165
Lead sponsor
Assiut University
Responsible party
Hala Saad Abdel-Ghaffar (Assisstant professor in anesthesia and intensive care, Faculty of medicine, Assiut university, Egypt., Assiut University) — Principal investigator
First posted
Sep 15, 2017
Start date
Sep 14, 2017
Primary completion
Sep 16, 2021 (estimated)
Completion
Sep 16, 2021 (estimated)
Last update
Jul 14, 2020

Study contacts

Hala S Abdelghaffar, MD
principal investigator · Assisstant professor in anesthesia and intensive care, faculty of medicine, Assiut university, Egypt

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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