Impact of Various Sedation Regimens on the Incidence of Delirium
Delirium
About this trial
This is an interventional treatment trial for Delirium focused on measuring Sedation;, ARDS;, Mechanical ventilation, Hypnotics, Antianxiety Drugs, Causing, Adverse Effects, Therapeutic Use
Eligibility Criteria
Inclusion Criteria:
- Subjects willing to give written informed consent.
- Mild, moderate or severe ARDS patients demanding invasive mechanical ventilation.
- Subjects whose expected time of mechanical ventilation is longer than 24 hours.
- Subjects aged between 18 and 70.
Exclusion Criteria:
- Subjects with extremely unstable circulation, whose SBP lower than 90mmHg after volume expansion or pressor agent treatment.
- Subjects with extremely unstable circulation, whose SBP lower than 90mmHg after volume expansion or pressor agent treatment.
- Subjects with heart rates less than 50 beats per minute.
- Subjects with second or third degree atrioventricular block.
- Subjects with serious cerebral injury, severe neurologic disorder (e.g acute stroke, uncontrolled epilepsy and severe dementia) or coma.
- Subjects with acute or severe liver disease (Child-Pugh class C), see attachment 2.
- ARDS patients caused by pulmonary fibrosis or COPD.
- Subjects on all types hemodialysis.
- Subjects with neuromuscular system disease, alcohol withdrawal syndrome or mental disease before entrance of ICU.
- Subjects suspected of narcotic analgesics abusing.
- Subjects needing neuromuscular blocking agents (except intubation).
- Subjects allergic to investigational products or with other contraindication.
- Subjects who are breastfeeding or pregnant
- Subjects participated in other study within 30 days before entrance of ICU
Sites / Locations
- HeNan Tumor Hospital
- The Second Hospital of Shandong University
- Affiliated Hospital of Jining Medical University
- Liaocheng Hospital
- Linyi People's Hospital
- Affiliated Hospital of Weifang Medical University
- Central Hospital of Zibo
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Dexmedetomidine,midazolam
Propofol,midazolam
Slow injection of 2mg midazolam every minute and watching patients' reaction until attaining the target level of sedation;midazolam was maintained at 0.02~0.1mg/kg/h, for 24 hours.Dexmedetomidine will be added at 0.2~1.4μg/kg/h to maintain sedation.If target sedation level (RASS score) cannot be reached in maximum dose of dexmedetomidine, continuous intravenous infusion of midazolam could be used at 0.02~0.1mg/kg/h, until the target level is reached.
Slow injection of 2mg midazolam every minute and watching patients' reaction until attaining the target level of sedation;midazolam was maintained at 0.02~0.1mg/kg/h, for 24 hours.Propofol will be added at 0.3~4mg/kg/h to maintain sedation.If target sedation level (RASS score) cannot be reached in maximum dose of propofol, continuous intravenous infusion of midazolam could be used at 0.02~0.1mg/kg/h, until the target level is reached.