The MENDS2 Study, Maximizing the Efficacy of Sedation and Reducing Neurological Dysfunction and Mortality in Septic Patients With Acute Respiratory Failure
NCT01739933 · Status: COMPLETED · Phase: PHASE3 · Type: INTERVENTIONAL · Enrollment: 438
Last updated 2021-06-07
Summary
Ventilated ICU patients frequently have sepsis and the majority have delirium, a form of brain dysfunction that is an independent predictor of increased risk of dying, length of stay, costs, and prolonged cognitive impairment in survivors. Universally prescribed sedative medications-the GABA-ergic benzodiazepines-worsen this brain organ dysfunction. The available alternative sedation regimens, the shorter acting GABA-ergic propofol, and the alpha2 agonist, dexmedetomidine, have both been shown to be superior to benzodiazepines, and yet are different with regard to their effects on innate immunity, bacterial clearance, apoptosis, cognition and delirium. The MENDS2 study will compare propofol and dexmedetomidine, and determine the best sedative medication to reduce delirium and improve survival and long-term brain function in our most vulnerable patients- the ventilated septic patient.
Conditions
- Sepsis
- Delirium
- Impaired Cognition
Interventions
- DRUG
-
Dexmedetomidine
For patients in the dexmedetomidine group, dose will range from 0.15-1.5 mcg/kg/hr. For example, a 70 kg patient would receive 10.5 mL of study drug per hour, which would provide 0.75 mcg/kg/hr of dexmedetomidine. This dose range have been selected after literature review and discussions with critical care practitioners, investigational pharmacists, and the MENDS2 study steering committee.
- DRUG
-
Propofol
For patients in the propofol group, dose will range from 5-50 mcg/kg/min. For example, a 70 kg patient would receive 10.5 mL of study drug per hour, which would provide 25 mcg/kg/min of propofol. This dose range has been selected after literature review and discussions with critical care practitioners, investigational pharmacists, and the MENDS2 study steering committee.
Sponsors & Collaborators
-
Vanderbilt University Medical Center
lead OTHER
Principal Investigators
-
Pratik P. Pandharipande, MD, MSCI · Vanderbilt University Medical Center
Study Design
- Allocation
- RANDOMIZED
- Purpose
- PREVENTION
- Masking
- TRIPLE
- Model
- PARALLEL
Eligibility
- Min Age
- 18 Years
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2013-05-15
- Primary Completion
- 2019-07-31
- Completion
- 2019-07-31
Countries
- United States
Study Locations
More Related Trials
-
Dexmedetomidine Versus Propofol in the Medical Intensive Care Unit (MICU)
NCT01059929 ·Status: TERMINATED ·Phase: PHASE4
-
Self-management of Sedative Therapy by Ventilated Patients
NCT02819141 ·Status: COMPLETED ·Phase: PHASE2/PHASE3
-
Low-Dose Dexmedetomidine for Delirium Prevention in Mechanically Ventilated Septic Patients
NCT04876937 ·Status: TERMINATED ·Phase: NA
-
Impact of Various Sedation Regimens on the Incidence of Delirium
NCT02117726 ·Status: UNKNOWN ·Phase: PHASE4
-
Dexmedetomidine for Continuous Sedation
NCT00226785 ·Status: TERMINATED ·Phase: PHASE3
-
Dexmedetomidine Versus Midazolam for Continuous Sedation in the Intensive Care Unit (ICU)
NCT00481312 ·Status: COMPLETED ·Phase: PHASE3
-
How Your Patients' Non-REM Sleep Changes On Sedatives in the Intensive Care Units
NCT00826553 ·Status: TERMINATED ·Phase: PHASE1
-
Dexmedetomidine Versus Propofol for Continuous Sedation in the Intensive Care Unit (ICU)
NCT00479661 ·Status: COMPLETED ·Phase: PHASE3
-
A Safety and Efficacy Study of Dexmedetomidine in ICU Patients Requiring Continuous Sedation
NCT00216190 ·Status: COMPLETED ·Phase: PHASE4
-
Dexmedetomidine for Sepsis in ICU Randomized Evaluation Trial
NCT01760967 ·Status: COMPLETED ·Phase: PHASE4
-
Randomized Controlled Trial of Dexmedetomidine for the Treatment of Intensive Care Unit (ICU) Delirium
NCT00351299 ·Status: COMPLETED ·Phase: PHASE2
-
The Psychological Effects of Different Sedation Protocol on Mechanically Ventilated Critically Ill Adults.
NCT02123589 ·Status: UNKNOWN ·Phase: PHASE4
-
Effects of Dexmedetomidine Sedation on Delirium and Haemodynamic in Mechanical Ventilated Elderly Patients
NCT02225210 ·Status: UNKNOWN ·Phase: PHASE4
-
Midazolam Used Alone or Sequential Use of Midazolam and Propofol/Dexmedetomidine in Mechanically Ventilated Patients
NCT02528513 ·Status: UNKNOWN ·Phase: PHASE4
-
Safety and Efficacy of Combined Sedation With Midazolam and Dexmedetomidine in ICU Patients
NCT02080169 ·Status: UNKNOWN ·Phase: PHASE4
-
The Effect of Analgesia Based Sedation Protocol on Brain Function of Critical Care Patients
NCT02078583 ·Status: UNKNOWN ·Phase: PHASE4
-
Does Nightly Dexmedetomidine Improve Sleep and Reduce Delirium in ICU Patients?
NCT01791296 ·Status: COMPLETED ·Phase: PHASE4
-
Dexmedetomidine-based Sedation in Neurocritical Care Patients
NCT02252523 ·Status: UNKNOWN ·Phase: PHASE2
-
Comparison of Dexmedetomidine and Propofol on the Delirium and Neuroinflammation in Patients With SIRS.
NCT02366299 ·Status: WITHDRAWN ·Phase: PHASE4
-
The Efficacy and the Safety of Dexmedetomidine Sedation on the Pediatric Intensive Unit(PICU) Patients.
NCT02296073 ·Status: UNKNOWN ·Phase: PHASE4
-
Effects of Dexmedetomidine on Postoperative Cognitive Dysfunction During One-lung Ventilation in Elder Patients
NCT02134093 ·Status: UNKNOWN ·Phase: PHASE4
-
Goal-Directed Sedation in Mechanically Ventilated Infants and Children
NCT04801589 ·Status: RECRUITING ·Phase: PHASE3
-
Investigation of Sleep in the Intensive Care Unit
NCT03355053 ·Status: COMPLETED ·Phase: PHASE2
-
Effects of Two Different Sedation Regimes on Auditory Evoked Potentials and Electroencephalogram (EEG)
NCT00641563 ·Status: COMPLETED ·Phase: NA
-
Sequential Use of Propofol/Midazolam and Dexmedetomidine for Sedation in Mechenical Ventialtion Patients in ICU.
NCT02122055 ·Status: UNKNOWN ·Phase: PHASE4