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Impact of Methadone on Prolonged Mechanical Ventilation in Patients on Continuous Treatment With Opioids

Phase 4
Not yet recruiting
Conditions
Effect of Methadone on the Duration on Mechanical Ventilation
Interventions
Drug: Usual care
Registration Number
NCT06110546
Lead Sponsor
The University of Texas Health Science Center, Houston
Brief Summary

The purpose of this study is to determine the effect of methadone on the duration on mechanical ventilation in critically ill patients receiving more than 72 hours of mechanical ventilation (MV) by comparing the number of ventilator free days from enrollment to the time of discharge, to assess the safety of methadone administration in critically ill patients while in the hospital and to determine hospital length of stay from the time of enrollment to the time of discharge

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Patients on Intermittent mandatory ventilation (IMV) for more than 72 hours
  • Patients infused Fentanyl or Hydromorphone for more than 72 hours
  • Patients with evidence of reversal of process that caused respiratory failure, adequate oxygenation (PaO2/fraction of inspired oxygen (FiO2)>200; Positive end expiratory pressure (PEEP)≤8 and Ph≥7.2
  • Patients hemodynamically stable
  • Patients with a failed single or multiple attempts at spontaneous breathing trials
Exclusion Criteria
  • Patients with history of opioid drug abuse
  • Patients receiving schedule II narcotics on a chronic basis for longer than 6 months prior to ICU admission or on other analgesic infusions other than Fentanyl or Hydromorphone
  • Patients with cervical spinal cord injury or neuromuscular disease
  • Patients with end stage liver disease at ICU admission (ie, International normalized ratio ≥2and not taking warfarin and/or a total serum bilirubin ≥1.5 times above normal limits
  • Patients with prolonged QTc interval ≥500
  • Patients with prior history of cardiac conduction defects or sudden death
  • Patients with QTc increase of ≥60 milliseconds above the value of prior EKGs measured during current ICU admission
  • Patients with more than 5 days on IV analgesia
  • Patients intubated for more than 3 days
  • Patients without feeding tubes
  • Patients not receiving enteral feeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Non-Methadone groupUsual care-
Methadone groupMethadone group-
Primary Outcome Measures
NameTimeMethod
Number of participants on methadone that get extubatedfrom day of intubation to day 5
Secondary Outcome Measures
NameTimeMethod
Number of participants that develop prolonged corrected QT interval (QTC) after administration of methadonefrom first day patient given Methadone to date patient discharged or transferred from hospital( upto about 7 days after admission )
ICU length of stayat time of discharge from ICU( upto about 3 days after admission )
hospital lengthat time of discharge from hospital ( upto about 7 days after admission )
hospital mortality.end of hospital stay ( upto about 7 days after admission )
ICU mortalityend of ICU stay ( upto about 3 days after admission )

Trial Locations

Locations (1)

The University of Texas Health Science Center at Houston

🇺🇸

Houston, Texas, United States

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