Evaluation of dexmedetomidine in intensive care unit patients with severe sepsis: a retrospective cohort study

Not Applicable

Completed

• Conditions: Sepsis; Mechanical ventilation; Cardiovascular - Other cardiovascular diseases; Anaesthesiology - Anaesthetics; Infection - Studies of infection and infectious agents

• Registration Number: ACTRN12615001071516
• Lead Sponsor: Austin Hospital

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2015-10-13
• Study Completion: 2020-07-15
• Last Update Posted: 16 February 2021

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 36

Inclusion Criteria

1.Aged 18 years or older
2.Subject has been intubated and is receiving mechanical ventilation
3.The treating clinician expects that the patient will remain intubated until the day after tomorrow (unlikely to be extubated the following day).
4.The patient requires immediate ongoing sedative medication for comfort, safety, and to facilitate the delivery of life support measures.
5.Documented site, or strong suspicion of infection with
6. 2 of the 4 clinical signs of inflammation (within the prior 24hours):
a) Core temperature greater than 38oC or less than 36oC
b) Heart rate greater than 90 bpm
c) Respiratory rate greater than 20 bpm, or PaCO2 less than 32 mmHg, or mechanical ventilation
d) White cell count greater than 12 x 109/L or less than 4 x 109/L or greater than 10% immature neutrophils
7.Treated with continuous vasopressors or inotropes to maintain a systolic blood pressure greater 90mmHg, or mean arterial blood pressure less than 60mmHg or a MAP target set by the treating clinician for maintaining perfusion
8.Administration of vasopressors or inotropes for greater than or equal to 4 hours and present at time of randomisation

Exclusion Criteria

1.Age less than 18 years
2.Patient is pregnant and/or lactating
3.Has been intubated (excluding time spent intubated within an operating theatre or transport) for greater than 12 hours in an intensive care unit
4.Met all inclusion criteria more than 24 hours before study inclusion
5.Patients treated with etomidate
6.Proven or suspected acute primary brain lesion such as traumatic brain injury, intracranial haemorrhage, stroke, or hypoxic brain injury.
7.Proven or suspected spinal cord injury or other pathology that may result in permanent or prolonged weakness
8.Admission as a consequence of a suspected or proven drug overdose or burns.
9.Administration of ongoing neuromuscular blockade
10.Mean arterial blood (MAP) pressure that is less than 50 mmHg despite adequate resuscitation and vasopressor therapy at time of randomisation
11.Heart rate less than 55 beats per minute unless the patient is being treated with a beta-blocker or a high grade atrio-ventricular block in the absence of a functioning pacemaker
12.Known sensitivity to any of the study medications or the constituents of propofol (egg, soya or peanut protein)
13.Acute fulminant hepatic failure
14.Patient has been receiving full time residential nursing care.
15.Death is deemed to be imminent or inevitable during this admission and either the attending physician, patient or substitute decision maker is not committed to active treatment.
16.Patient has an underlying disease that makes survival to 90 days unlikely

Study & Design

• Study Type: Observational
• Study Design: Not specified