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Agents Intervening Against Delirium in Intensive Care Unit

Phase 4
Active, not recruiting
Conditions
Delirium
Interventions
Other: Saline (0,9%)
Registration Number
NCT03392376
Lead Sponsor
Zealand University Hospital
Brief Summary

Delirium is a frequent condition in the Intensive Care Unit (ICU) with no existing evidence-based treatment. The aim of the AID-ICU study is to assess the benefits and harms of haloperidol treatment for the management of ICU acquired delirium.

Detailed Description

Delirium among critically ill patients in the intensive care unit (ICU) is a common condition associated with increased morbidity and mortality. No evidence-based treatment exist of this condition. Haloperidol is the most frequently used agent to treat ICU-related delirium, but according to the available literature there is no firm evidence of efficacy and safety of this intervention. AID-ICU aims to assess the benefits and harms of haloperidol in adult, critically ill patients with delirium in the ICU.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
1000
Inclusion Criteria
  • Acute admission to the ICU AND
  • Age ≥ 18 years AND
  • Diagnosed delirium with validated screening Tool as either CAM-ICU or ICDSC
Exclusion Criteria
  • Contraindications to haloperidol
  • Habitual treatment with any antipsychotic medication or treatment with antipsychotics in the ICU prior to inclusion
  • Permanently incompetent (e.g. dementia, mental retardation)
  • Delirium assessment non-applicable (coma or language barriers)
  • Withdrawal from active therapy
  • Fertile women (women < 50) with positive urine human chorionic gonadotropin (hCG) or plasma hCG.
  • Consent according to national regulations not obtainable
  • Patients under coercive measures by regulatory authorities
  • Patients with alcohol-induced delirium (Delirium Tremens)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Haloperidol injectionHaloperidol InjectionHaloperidol 2,5mg x 3 daily, with additional as needed doses to a maximum of 20mg/daily. Other name: Serenase
Normal SalineSaline (0,9%)Saline (0,9%)
Primary Outcome Measures
NameTimeMethod
Days alive out of the hospital within 90 days post-randomization90 days

Number of days alive and out of hospital

90-day mortality90 days

Death from any cause within 90 days post-randomization

Hospital Length of Stay90 days

Total number of days the patient is admitted to any hospital within the 90-day intervention period

Secondary Outcome Measures
NameTimeMethod
Mortality1 year

Landmark mortality 1 year post-randomisation

Number of days alive without mechanical ventilation within 90 days postrandomisationMeasured every day from inclusion until ICU discharge, maximum 90 days

Number of days where patients are both alive and free of mechanical ventilation

Quality of life (five level)1 year

EQ-5D-5L total score 1 year post-randomisation (1-5 of each of the five domains)

Quality of life (overall self assessment)1 year

EQ-Visual Analogue Scale 1 year post-randomisation (0-100)

Cognitive function at admissionAt inclusion (within the first week)

Informant Questionnaire on Cognitive Decline in the Elderly at ICU admission at selected sites (40-150)

Number of patients with one or more serious adverse reactions to haloperidol and the total number of serious adverse reactions to haloperidol compared with placeboMeasured every day from inclusion until ICU discharge, maximum 90 days

Serious adverse reactions are: Anaphylactic reactions, Agranulocytosis, Pancytopenia, Ventricular arrhythmia, Extrapyramidal symptoms, Tardive dyskinesia, Malignant Neuroleptic Syndrome, Acute hepatic failure

Usage of escape medicineMeasured every day from inclusion until ICU discharge, maximum 90 days

Number of patients receiving escape medicine and number of days with escape medicine per patients

Number of days alive without delirium or coma in the ICUUntil ICU discharge, maximum 90 days

Number of days where patients are both alive and free of delirium and coma

Executive function 1 year after randomisation at selected sites1 year

Trail Making Test 1 year post-randomisation at selected sites (40-150)

Cognitive function 1 year after randomisation at selected sites1 year

Repeated Battery for the Assesment of Neuropsychological Status score 1 year post-randomisation at selected sites (40-150)

A health economic analysis90 days

The analytic details will be based on the primary results of the trial (cost-benefit or cost-minimisation analyses)

Trial Locations

Locations (16)

Dept. Intensive Care, Aabenraa Hospital

🇩🇰

Aabenraa, Denmark

Dept. of Intensive Care, Aalborg University Hospital

🇩🇰

Aalborg, Denmark

Dept. of Intensive Care, Sønderborg Hospital

🇩🇰

Sønderborg, Denmark

Dept of intensive care, Odense University Hospital

🇩🇰

Odense, Denmark

Dept. of Intensive Care, Helsinki University Central Hospital

🇫🇮

Helsinki, Finland

Dept. of Neurosurgical Intensive Care, San Gerardo Hospital, Monza.

🇮🇹

Monza, Italy

UHW Adult Critical Care Cardiff

🇬🇧

Cardiff, United Kingdom

Dept. of Intensive Care, Herlev Hospital

🇩🇰

Herlev, Denmark

Dept. of Intensive Care, Herning Hospital

🇩🇰

Herning, Denmark

Dept. of Intensive Care, Nordsjaelland Hospital

🇩🇰

Hillerød, Denmark

Dept. of Intensive Care 4131, Copenhagen University Hospital, Rigshospitalet

🇩🇰

Copenhagen, Denmark

Regionshospitalet Nordjylland, Hjørring

🇩🇰

Hjørring, Denmark

Dept. of Intensive Care, Holstebro Hospital

🇩🇰

Holstebro, Denmark

Dept. of Intensive Care, Zealand University Hospital, Køge

🇩🇰

Køge, Denmark

Dept. of Intensive Care, Nykøbing Falster Hospital

🇩🇰

Nykøbing Falster, Denmark

Dept. of Intensive Care, Zealand University Hospital Roskilde

🇩🇰

Roskilde, Denmark

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