MedPath

Effect of Minocycline on Delirium Incidence in Critically Ill Patients

Phase 2
Completed
Conditions
Delirium
Coma
Interventions
Drug: Placebos
Registration Number
NCT04219735
Lead Sponsor
Universidade do Extremo Sul Catarinense - Unidade Academica de Ciecias da Saude
Brief Summary

Delirium is a disorder of consciousness characterized by an acute onset and fluctuating course of impaired cognitive functioning. It is associated with unfavorable outcomes in hospitalized patients, including longer hospital length of stay, need for subsequent institutionalization and higher mortality rates. Patients in the intensive care unit (ICU) under mechanical ventilation and older age are at higher risk for the development of delirium. Several studies suggest that minocycline, through its anti-inflammatory effect, was able to prevent neuronal dysfunction in different models of ICU-related diseases. Thus, the present study aimed to evaluate the effect of minocycline on delirium development in critically ill patients. Patients will be randomized into one of two groups: the intervention group that will receive 100mg of minocycline 2 times a day and the placebo group. Medication or placebo will be continued for 28 days or until ICU discharge (whichever occurs first). Delirium will be diagnosed by the CAM-ICU. Coma will be defined by the Richmond Agitation-Sedation Scale (RASS) score of -4 or -5 and biomarkers will be used as alternative outcomes related to the pathophysiology of the disease (IL-1, IL-6, IL-10, and BDNF).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
160
Inclusion Criteria
  • Clinical or surgical patients,
  • Over 18 years,
  • Expected ICU stay of at least 2 days estimated by the attending intensivist,
  • Agree to participate in the study
Exclusion Criteria
  • Delirium prior to inclusion,
  • Diagnosis of Parkinson's disease
  • Diagnosis of dementia,
  • Alcohol abuse history,
  • Acute neurological condition at admission
  • History of psychiatric disease
  • Use of antipsychotics
  • Pregnant or breastfeeding women,
  • Expectation of death within 2 days
  • Hospitalized for exclusive palliative care
  • Known allergy to minocycline

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlacebosPlacebo capsules identical to experimental arm
MinocyclineMinocyclineMinocycline 100 mg BID
Primary Outcome Measures
NameTimeMethod
Delirium and subsyndromal delirium incidence during ICU stayup to 28 days

Number of patients with delirium

Secondary Outcome Measures
NameTimeMethod
Days in delirium during ICU stayup to 28 days

Number of days being in delirium

Length of ICU stayup to 28 days

Number of days in the ICU

Long-term quality of life measured by the 12-Item Short-Form Health Survey V2until 12 months after hospital discharge

Quality of life measured after hospital discharge

Long-term cognitive dysfunction measured by Montreal Cognitive Assessment scoreuntil 12 months after hospital discharge

Cognitive function after hospital discharge

Coma-delirium free days during ICU stayup to 28 days

Number of days free of coma or delirium

Long-term depression and anxiety symptoms measured by Hospital Anxiety and Depression Scaleuntil 12 months after hospital discharge

Depression and anxiety symptoms after hospital discharge measured by Hospital Anxiety and Depression Scale, ranging from 0 to 21, higher values indicate more severe symptoms

Length of mechanical ventilation during ICU stayup to 28 days

Number of days in mechanical ventilation

ICU mortalityup to 28 days

Number of dead during ICU stay

Hospital mortalityup to 90 days

Number of dead during hospital stay

Plasma levels of interleukin-6, interleukin-10, brain derived neural factor and S100-BAt Day 1 and 3 of ICU stay, and hospital discharge

Inflammatory and brain derived plasma biomarker levels

Long-term Post-Traumatic Stress Disorder measured by Impact of Event Scale-Reviseduntil 12 months after hospital discharge

Post-Traumatic Stress Disorder symptoms after hospital discharge measured by the Impact of Event Scale-Revised ranging from 0 to 88, higher values indicate more severe symptoms

Trial Locations

Locations (1)

São José Hospital

🇧🇷

Criciuma, SC, Brazil

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