Clinical trial NCT02035436: Non-sedation Versus Sedation With a Daily Wake-up Trial in Critically Ill Patients Receiving Me-chanical Ventilation - Effects on Cognitive Function
Official title: Substudy of the NONSEDA Trial (NCT01967680): Non-sedation Versus Sedation With a Daily Wake-up Trial in Critically Ill Patients Receiving Me-chanical Ventilation - Effects on Cognitive Function
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Delirium
Cognition Disorders
Keywords: Respiration, artificial
Critcal care
Lead sponsor: Odense University Hospital
Sponsor class: OTHER
Collaborators: name: Kolding Sygehus
name: University of Southern Denmark
name: The Danish Council for Strategic Research
First posted: 2014-01-14
Enrollment: 205
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: Through many years, the standard care has been to use continuous sedation of critically ill patients during mechanical ventilation. However, preliminary randomised clinical trials indicate that it is beneficial to reduce the sedation level in these patients. The NONSEDA trial is an investigator-initiated, randomised, clinical, parallel-group, multinational, superiority trial designed to include 700 patients from at least six ICUs in Denmark, Norway and Sweden, comparing no sedation with sedation and a daily wake-up trial during mechanical ventilation. This is a substudy of the NONSEDA trial, concerning 250 patients included at trialsite Kolding, Denmark. The aim of the substudy is to assess the effects of no sedation on delirium during admission and cognitive function after discharge from ICU.

Our hypothesis is that critically ill patients who are not sedated during mechanical ventilation will have better cognitive function after discharge.


Eligibility criteria: Inclusion Criteria:

* Endotracheally intubated
* Expected time on ventilator \> 24 hours
* Age ≥ 18 years
* Informed consent

Exclusion Criteria:

* Severe head trauma where therapeutic coma is indicated
* Therapeutic hypothermia where therapeutic coma is indicated
* Status epilepticus where therapeutic coma is indicated
* Patient has participated in the study before
* Patient is transferred from another ICU with length of stay \> 48 hours
* Patient is comatose at admission
* PaO2/FiO2 ≤ 9, if sedation is necessary for oxygenation
* Patient does not speak Danish, swedish or norwegian at a reasonable level

Primary outcomes:
measure: Cognitive function
timeFrame: 3 months after discharge from ICU
Secondary outcomes:
measure: Attention/concentration
timeFrame: 3 months after discharge from ICU
measure: Learning/memory
timeFrame: 3 months after discharge from ICU
measure: Executive dysfunction
timeFrame: 3 months after discharge from ICU
measure: Mental pace
timeFrame: 3 months after discharge from ICU
measure: Hypoactive delirium
timeFrame: 3 months after discharge from ICU
measure: Agitated delirium
timeFrame: 3 months after discharge from ICU
Other outcomes:
Locations:
city: Kolding
country: Denmark
facility: Lillebaelt Hospital, Kolding, Intensive Care Unit
Study officials:
affiliation: Lillebaelt Hospital, Kolding
name: Helene Joergensen, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Nedergaard HK, Jensen HI, Stylsvig M, Lauridsen JT, Toft P. Non-sedation versus sedation with a daily wake-up trial in critically ill patients recieving mechanical ventilation - effects on long-term cognitive function: Study protocol for a randomized controlled trial, a substudy of the NONSEDA trial. Trials. 2016 Jun 1;17(1):269. doi: 10.1186/s13063-016-1390-5.