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TerminatedNCT03407404KeMiMofUpdated Aug 28, 2019

Comparing Clinical Outcomes Between Ketamine-midazolam and Morphine-midazolam for Continous Sedation in ICU Patients.

A Phase 2/3 interventional study of Ketamine-Midazolam and Morphine -Midazolam in Critical Illness, sponsored by Makerere University. Terminated at 1 site in Uganda. Open to participants aged 12 Years and older. Per ClinicalTrials.gov, last updated 2019-08-28.

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

Why this study was terminated
Futility
Phase
Phase 2/3
Study type
Interventional
Enrollment
124
Allocation
Randomized
Ages
12 Years and older
Sex
All
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Study summary

A prospective, double-blinded, multicenter randomized control trial. All critically ill patients above 12 years of age requiring continuous sedation for >24hrs in the ICU will be screened and those meeting selection criteria (and consented) will be enrolled into the study.

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Read the detailed description

165 participants shall be consecutively randomized into either sedation with ketamine-midazolam or morphine-midazolam group using a block sequence technique; group concealed in brown envelopes. Blinding will be at patient/next of kin level as well as investigator/data collector level.

Enrolled subjects shall be followed up for treatment history, co-morbidities and related data will be collected, results analyzed and study findings will be availed to ICU physicians and Ministry of health to guide treatment considerations and for health care planning.

Data shall be collected using a standardized questionnaire by trained research assistants. It will be double entered into Epidata and exported to STATA version 12.0 for analysis. Continuous variables will be expressed as means and standard deviations, while categorical data will be expressed as frequencies with their respective percentages. Linear regression and logistic regression used to analyse primary outcomes, as well as multivariate analysis to detect associations.

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Conditions studied

  • Critical Illness

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03

Who can participate

Ages eligible
12 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Age >12years of age.
  2. Anticipated need for sedation for >24hours.

Exclusion criteria

Exclusion Criteria:

  1. Hypertensive crisis i.e. sustained SBP >200mmHg/DBP>110mmHg
  2. Status epilepticus
  3. Ischemic heart disease and severe LV dysfunction
  4. Persistent tachyarrythmias
  5. History of mental illness
  6. Hypersensitivity to ketamine, morphine or midazolam.
  7. Tetanus -due to the muscle rigidity that may be caused by ketamine. Reasons for exclusions 1 to 4; Ketamine stimulates the sympathetic nervous system causing transient increase in myocardial work and blood pressure and has psychoactive effects
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Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
124 participants (actual)

Study arms

  • Experimental
    Ketamine-midazolam

    Continous intravenous sedation with a colorless drug mixture in 50ml syringe containing 900mg ketamine and 36mg midazolam.

    Combination Product: Ketamine-Midazolam

  • Active comparator
    Morphine-Midazolam

    Continous intravenous sedation with a colourless drug mixture in 50ml syringes containing 54mg morphine and 36mg midazolam.

    Combination Product: Morphine -Midazolam

Interventions

  • Combination productKetamine-Midazolam

    Continous intravenous sedation with 36mg of Midazolam and 900mg of Ketamine mixed in 50ml syringes as long as patient still requires sedation.

  • Combination productMorphine -Midazolam

    Continous intravenous sedation with 54mg of Morphine Sulphate and 36mg of midazolam mixed in 50ml syringes as long as participant still requires sedation.

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What researchers measure

Primary outcomes

  1. duration of mechanical ventilation

    in hours from start of mechanical ventialtion

    Time frame: 14 days

  2. incidence of hypotension

    incidence of hypotension requiring vasopressor support.

    Time frame: 14 days

  3. incidence of delirium

    assessed daily with the CAM-ICU score

    Time frame: 14 days

Secondary outcomes

  1. ICU length of stay

    length of stay in the intensive care unit from enrollment.

    Time frame: 14 days

  2. mortality rate

    number of deaths in each study arm

    Time frame: within 14 days

06

Study locations

1 site
  • Mulago National Referral Hospital ICU
    Kampala, Central 256, Uganda
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

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Registry details

Key details

Study ID
NCT03407404
Lead sponsor
Makerere University
Collaborators
THRiVE
Responsible party
Sponsor
First posted
Jan 23, 2018
Start date
Oct 22, 2017
Primary completion
Jun 15, 2019
Completion
Jul 30, 2019
Last update
Aug 28, 2019

Study contacts

Christine Namata, MBChB
principal investigator · Makerere University

Oversight

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

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