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Midazolam Whole Body Physiologically Based Pharmacokinetic Model

Completed
Conditions
Coma
Respiratory Failure
Registration Number
NCT01973894
Lead Sponsor
Università degli Studi dell'Insubria
Brief Summary

This study investigates what independent variables may influence Midazolam Pharmacokinetics in critically ill patients.

Detailed Description

This study has three specific aims:

1. to create a Midazolam PBPK model based on anthropometric and physiopathological data from enrolled patients;

2. to estimate cerebral and systemic Midazolam concentrations;

3. to assess independent variables about Midazolam pharmacokinetic in critically ill patients.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria
  • ICU admittance
  • Caucasian
  • Clinical indication of least 72h of continuous sedation with Midazolam
  • MAP between 60 - 150 mmHg, even if obtained with amine support
  • informed consent obtained
Exclusion Criteria
  • Any endocranial lesion, spontaneous or induced
  • PaCO2 > 60 mmHg or < 30 mmHg
  • PaO2 < 50 mmHg
  • Pregnancy
  • Anuria
  • Any transplantation
  • Severe hepatic failure (Child C)
  • Life expectancy < 72h
  • Ketoconazole and antiretrovirals in therapy

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Midazolam concentration in serum and urineParticipants will be followed for the duration of hospital stay, an expected average of 3 weeks

We will calculate Midazolam AUC in serum and urine using blood and urine samples. With this data we will evaluate the elimination constants and create a Physiologically Based Pharmacokinetic Model for Midazolam simulating the drug concentration profile in brain and fat tissue.

The blood and urine samples timing is:

* 1 blood sample will be gathered after 24h at the beginning of continuous intravenous infusion of Midazolam

* 1 blood sample and 1 urine sample will be gathered after 48h at the beginning of continuous intravenous infusion of Midazolam

* 1 blood sample will be gathered at the end of continuous intravenous infusion of Midazolam (the duration of infusion is different for each patient according with clinical case)

* 1 blood sample and 1 urine sample will be gathered after 6h at the end of continuous intravenous infusion of Midazolam (the duration of infusion is different for each patient according with clinical case)

Secondary Outcome Measures
NameTimeMethod
Fat mass analysis and its importance in drug distribution.At enrollment

At enrollment we will collect data about fat mass in our population. Our goal is to determine how much this variable can modify the distribution of Midazolam in the body. Statistical analysis will performed to found if different body mass values are correlated with different blood concentration of Midazolam at steady level.

Trial Locations

Locations (1)

Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi

🇮🇹

Varese, Italy

Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi
🇮🇹Varese, Italy

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