Advertisement

Topics

Adjunctive Clonidine in the Sedation of Mechanically Ventilated Children

2014-08-27 03:20:02 | BioPortfolio

Summary

Almost all critically ill children who are mechanically ventilated require sedation and analgesia. Providing effective sedation for children in the PICU requires careful balancing of the need for sedation with the adverse effects associated with sedative medications. Clonidine is often used as an adjunctive sedative and analgesic in children but a well designed and adequately powered randomized trial is required to test the effect of clonidine-based sedation. Because there are no large randomized trials of sedation related interventions among critically ill children there are many unknown factors. This pilot trial, focussing on feasibility outcomes will assess the feasibility of, and inform the design of, a larger randomized controlled trial which will focus on clinically important outcomes.

Description

Almost all critically ill children who are mechanically ventilated require sedation and analgesia. Providing effective sedation for children in the PICU requires careful balancing of the need for sedation with the adverse effects associated with sedative medications. Inadequate sedation may result in undue pain and suffering for children, ventilator dysynchrony and may risk removal of life sustaining devices. Excess sedation limits patients' interaction with their parents and care-givers and may result in delayed weaning from mechanical ventilation, prolonged PICU stay and the attendant risks of increased morbidity. Critically ill children may also experience withdrawal when these medications are stopped. Randomized trails in adults have shown that sedation related interventions can improve patients outcomes, but such trials have not been performed in children.

Clonidine is often used as an adjunctive sedative and analgesic in children but a well designed and adequately powered randomized trial is required to test the effect of clonidine-based sedation. Because there are no large randomized trials of sedation related interventions among critically ill children there are many unknown factors.

This pilot trial, focussing on feasibility outcomes will assess the feasibility of, and inform the design of, a larger randomized controlled trial which will focus on clinically important outcomes.

Study Design

Allocation: Randomized, Control: Placebo Control, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Conditions

Respiration, Artificial

Intervention

clonidine, placebo

Location

McMaster Children's Hospital/Hamilton Health Sciences
Hamilton
Ontario
Canada
L8n 3Z5

Status

Recruiting

Source

McMaster University

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:20:02-0400

Clinical Trials [342 Associated Clinical Trials listed on BioPortfolio]

Clonidine-Remifentanil. Effect of the Combination on Acute Pain and Respiration in Healthy Volunteers

The hypothesis is that systemic remifentanil and Clonidine act in a synergistic manner to relief acute main in an experimental human pain model. Of interest is also the effect of the combi...

Effect of Clonidine on Imagery Scripts

This is a study of the effects of clonidine: how it affects responses to stress and to things that remind people of drugs. Clonidine is being compared to placebo. Participants listen to ...

Clonidine and Left Ventricular Dysfunction

The objectives of this study are: 1. To evaluate the effect of clonidine, a sympathetic modulator, to reverse cardiac remodeling and to improve hemodynamics in diastolic heart fail...

Clonidine for Prevention of Relapse to Opiate Abuse

The purpose of the study is to determine whether clonidine, given to abstinent patients maintainedon buprenorphine, prevents relapse to opioid use more effectively than placebo.

Comparison of Keppra and Clonidine in the Treatment of Tics

The goal of this study is to confirm that levetiracetam has a better tic-suppressing profile than that of the widely used tic-suppressing medication, clonidine. More specifically, we hypo...

PubMed Articles [2827 Associated PubMed Articles listed on BioPortfolio]

Effects of Clonidine on the Cardiovascular, Renal and Inflammatory Responses to Experimental Bacteremia.

Supra-clinical doses of clonidine appear beneficial in experimental sepsis, but there is limited understanding of the effects of clonidine at clinically relevant doses.

The effects of beta blockade and clonidine on persistent injury-associated anemia.

Nonselective beta blockade (BB) and clonidine may abrogate catecholamine-mediated persistent injury-associated anemia. We hypothesized that critically ill trauma patients who received BB or clonidine ...

Ameliorative effects of clonidine on ethanol induced kidney injury in rats: Potential role for imidazoline-1 receptor.

Chronic alcoholism is a risk factor for kidney injury. Clonidine is an α-adrenergic receptor/imidazoline-1 receptor agonist that can reduce blood pressure and maintain renal functions. This study aim...

Comparison of outcomes between morphine and concomitant morphine and clonidine treatments for neonatal abstinence syndrome.

To examine whether adding clonidine to the morphine regimen for treatment of neonatal abstinence syndrome (NAS) is associated with a shorter length of treatment compared to morphine alone.

Placebo analgesia persists during sleep: An experimental study.

Although placebo analgesia is a well-recognized phenomenon with important clinical implications, the possibility that placebo effects occur during sleep has received little attention. This experimenta...

Medical and Biotech [MESH] Definitions

Artificial respiration (RESPIRATION, ARTIFICIAL) using an oxygenated fluid.

Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2).

The artificial substitution of heart and lung action as indicated for HEART ARREST resulting from electric shock, DROWNING, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation (RESPIRATION, ARTIFICIAL) and closed-chest CARDIAC MASSAGE.

Techniques for administering artificial respiration without the need for INTRATRACHEAL INTUBATION.

The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= OXYGEN CONSUMPTION) or cell respiration (= CELL RESPIRATION).

More From BioPortfolio on "Adjunctive Clonidine in the Sedation of Mechanically Ventilated Children"

Advertisement
Quick Search
Advertisement
Advertisement

 

Relevant Topics

Pediatrics
Pediatrics is the general medicine of childhood. Because of the developmental processes (psychological and physical) of childhood, the involvement of parents, and the social management of conditions at home and at school, pediatrics is a specialty. With ...

Pain
Pain is defined by the International Association for the Study of Pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”. Some illnesses can be excruci...

Anesthesiology
An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine. Anesthesiologists are physicians who provide medical care to patients in a wide variety of (usually acute) situations. ...


Searches Linking to this Trial