Nocturnal dexmedetomidine for prevention of delirium in critically ill surgical patients: a randomized control trial protocol

Nocturnal dexmedetomidine for delirium prevention in ICU

Authors

  • Raksakul Kuanha Division Critical Care Medicine, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Thanus Teeratitayang-gool Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Annop Piriyapassom Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Nuanprae Kitisin Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Napat Thikom Division of Nursing, Faculty of Medicine, Siriraj Hospital, Mahidol University
  • Onuma Chaiwat Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University

DOI:

https://doi.org/10.54205/ccc.v30.254777

Keywords:

Dexmedetomidine, Surgical intensive care, Postoperative delirium, Prevention

Abstract

Background: Nocturnal or postoperative dexmedetomidine has been shown to reduce the incidence of delirium in critically ill surgical patients without an increase in any complications. However, it is not clear whether dexmedetomidine has preventive effect against delirium in the patients with high risk of postoperative delirium (POD) since no previous studies have clearly emphasized high-risk surgical patients.

Method: In this single-center, double-blind, randomized controlled trial, we randomize 114 high risk POD patients defined by developed predictive scores and admitted to surgical intensive care units (SICUs) into 2 groups: nocturnal dexmedetomidine (9 pm – 6 am) and placebo. The outcomes were incidence of POD, delirium-free days, secondary delirium-related complications and concerned complications including hypotension and bradycardia. Other treatments apart from intervention are standardized. Intention to treat analysis is used to analyze all data.

Hypothesis: We hypothesize that nocturnal dexmedetomidine giving to high-risk POD patients admitted to SICUs postoperatively would (1) reduce incidence of POD (2) improve delirium-free days (3) reduce secondary delirium-related complications (4) show no difference in hypotension and bradycardia between groups.

Ethics and dissemination: The trial receives ethic approval from Siriraj Institutional Review Board. We plan to disseminate the results in peer-reviewed critical care medicine or anesthesiology-related journals, conferences nationally and internationally.

Trial registration: TCTR20210217001

References

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Published

2022-02-04

How to Cite

1.
Kuanha R, Teeratitayang-gool T, Piriyapassom A, Kitisin N, Thikom N, Chaiwat O. Nocturnal dexmedetomidine for prevention of delirium in critically ill surgical patients: a randomized control trial protocol: Nocturnal dexmedetomidine for delirium prevention in ICU. Clin Crit Care [Internet]. 2022 Feb. 4 [cited 2024 Jul. 16];30:2022:e0001. Available from: https://he02.tci-thaijo.org/index.php/ccc/article/view/254777

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Section

Research Protocol