Effects of Dexmedetomidine in Patients With Agitated Delirium in Palliative Care

Launched by BRUYÈRE HEALTH RESEARCH INSTITUTE. · Mar 30, 2021

Keywords

ClinConnect Summary

This clinical trial is studying the effects of a medication called dexmedetomidine on patients who are experiencing a condition known as agitated delirium, particularly those receiving palliative care as they approach the end of life. The goal is to find out if this medication can help manage agitation and improve overall comfort for these patients. The trial will involve 50 participants who will receive dexmedetomidine through an injection under the skin, starting at a low dose and gradually increasing it as needed. Researchers will closely monitor how well the treatment works and if there are any side effects.

To be eligible for this trial, patients need to be at least 18 years old and admitted to a palliative care unit. They should be experiencing signs of agitated delirium or have a history of delirium in the past six months. However, patients with certain health issues, like very low blood pressure or specific heart conditions, cannot participate. Throughout the study, participants can expect to be regularly evaluated for their agitation and comfort levels, and the findings may help improve treatment for others in similar situations in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Adult patients (≥18 years)
• • 2. Admitted to a participating inpatient palliative care unit
• 3. Meeting one of the following criteria:
• • 1. Agitated delirium: (i) Richmond Agitation-Sedation Scale for palliative care patients (RASS-PAL) score of +2 or greater and (ii) Confusion Assessment Method (CAM) positive status and (iii) Without a known potentially reversible cause (e.g. hypercalcemia, specific medication infection, etc.), or in whom the patient/Substitute Decision Maker (SDM) has requested not to treat the cause.
• • 2. Previous history of delirium (in the last 6 months)
• • 3. Patient is within the last two weeks of life and is expected to die during this admission (MRP judgement)
• Exclusion Criteria:
• • 1. Hemodynamic instability (systolic blood pressure \<80mmHg)
• • 2. Bradyarrhythmia (heart rate \< 60) at baseline
• • 3. Patients on verapamil, diltiazem, or beta-blocker (patients are eligible if these medications are stopped prior to receiving dexmedetomidine)