Dexmedetomidine and Outcomes of Elderly Admitted to ICU After Surgery

Launched by PEKING UNIVERSITY FIRST HOSPITAL · Dec 18, 2019

Keywords

ClinConnect Summary

This clinical trial is looking at how a medication called dexmedetomidine can help improve the recovery and long-term outcomes for elderly patients who are admitted to the Intensive Care Unit (ICU) after non-cardiac surgery. Previous research has shown that low doses of dexmedetomidine can enhance sleep quality and reduce confusion (delirium) in these patients, which may lead to better survival rates and improved quality of life over time. The goal of this study is to see if these benefits continue in the long run for older patients.

To be eligible for this trial, participants must be at least 65 years old and have undergone non-cardiac surgery that requires a stay in the ICU. They should be expected to stay in the ICU until the next morning. However, patients with certain health conditions, such as severe heart or lung problems, or a history of specific neurological disorders, are not eligible. If you or a loved one qualifies for this study, you can expect to receive low-dose dexmedetomidine during your ICU stay, and researchers will follow your progress over time to learn more about its effects on recovery and survival.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age ≥65 years old;
• • Admitted to intensive care unit (ICU) after noncardiac surgery;
• • Expected to stay in ICU until the next morning. For those with endotracheal intubation, the expected duration of mechanical ventilation is \<24 hours;
• • Provide written informed consents.
• Exclusion Criteria:
• • Preoperative history of schizophrenia, epilepsy, Parkinsonism, or myasthenia gravis;
• • Inability to communicate in the preoperative period (coma, profound dementia, or language barrier);
• • Preoperative history of sleep apnea (previous diagnosis; or STOP-Bang score ≥3 with serum bicarbonate ≥ 28 mmol/L);
• • Known sick sinus syndrome, severe sinus bradycardia (\<50 beats per min \[bpm\]), or second degree or higher atrioventricular block without pacemaker;
• • Hypotension (systolic blood pressure \[SBP\] \<90 mmHg, mean arterial pressure \[MAP\] \<70 mmHg, or a decrease of SBP \>30% of baseline) or in a state of shock (vasopressors are required to maintain MAP ≥65 mmHg and serum lactate \>2 mmol/L);
• • Severe hepatic dysfunction (Child-Pugh class C), renal failure (requirement of renal replacement therapy), or expected survival \<24 hours;
• • Traumatic brain injury or neurosurgery;
• • Presence of delirium before surgery (assessed with Confusion Assessment Method \[CAM\]/CAM-ICU);
• • Undergoing treatment of dexmedetomidine or clonidine;
• • Other conditions that are considered unsuitable for study participation.