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Dexmedetomidine for Analgosedation to Newborn Infants During Neonatal Intensive Care

Dexmedetomidine for Analgosedation to Newborn Infants During Neonatal Intensive Care - a Prospective Pharmacokinetic/ Pharmacodynamic/ Pharmacogenetic Observational Study.Cohort 3 in The SANNI Project.

Status
Withdrawn
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT06482775
Enrollment
0
Registered
2024-07-01
Start date
2021-06-01
Completion date
2021-12-31
Last updated
2024-07-01

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Analgesia, Hypnotics and Sedatives, Intensive Care, Neonatal

Brief summary

A prospective pharmacokinetic (PK), pharmacodynamic (PD) and pharmacogenetic (PG) observation study, including the PK/PD/PG relationship, on dexmedetomidine administered for analgesia and sedation to postsurgical and other newborn sick infants needing the drug for clinical reasons during neonatal intensive care. Phase III - therapeutic confirmatory study.

Detailed description

The patients will be treated according to clinical guidelines and judgement as decided by the responsible clinical doctor. The dosing and administration of dexmedetomidine will be implemented according to an algorithm based on pain scoring results. Apart from extra blood sampling and extended bedside monitoring for amplitude-integrated EEG (aEEG), Near InfraRed Spectroscopy (NIRS), and Galvanic Skin Response (GSR) the care is according to clinical routine. In total 100 infants will be included.

Interventions

DRUGdexmedetomidine

The dosing and administration will be implemented according to an algorithm based on pain scoring results

Sponsors

Lund University
CollaboratorOTHER
Karolinska Institutet
CollaboratorOTHER
Helsinki University Central Hospital
CollaboratorOTHER
Great Ormond Street Hospital for Children NHS Foundation Trust
CollaboratorOTHER
Örebro University, Sweden
CollaboratorOTHER
The Swedish Research Council
CollaboratorOTHER_GOV
University of Tartu
CollaboratorOTHER
University of Colorado, Denver
CollaboratorOTHER
Region Skane
Lead SponsorOTHER

Study design

Observational model
CASE_ONLY
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
No minimum to 27 Days
Healthy volunteers
No

Inclusion criteria

* Newborn infants: - born 34+0 gw with a need for dexmedetomidine for analgesic and/or sedative treatment after postnatal surgical correction of congenital malformations and who will be cared for in the PICU (postoperative intensive care unit) and in a some few cases in the NICU (neonatal intensive care unit), or * with a corresponding age of 37 gw, who are in need for dexmedetomidine according to clinical judgment and cared for in the NICU. * Existing arterial or venous cannulas/catheters for repeated nontraumatic blood sampling * Informed and written parental consent obtained before study start.

Exclusion criteria

* Infant older than age corresponding to gw 46+0 * Previous treatment with the dexmedetomidine within 72 hours (only for postoperative infants). * Congenital cardiac malformations requiring surgery on extracorporeal circulation and treatment with hypothermia. * Ongoing renal replacement treatment * Any serious medical condition or ethical issues that could, in the investigators opinion, interfere with the study procedures.

Design outcomes

Primary

MeasureTime frameDescription
Pharmacokinetics (PK) of dexmedetomidineRepeated blood samples (5 minutes after the loading dose until 12 hours after stop of infusion)The plasma concentration will be analysed and then further reported using NONMEM® (Non-linear Mixed Effect Modelling) population-based PK modelling.
Neurophysiologic response; global brain network function in relation to PKBaseline until 12 hours after stop of infusionAssessment of global brain network function will be based on Activation Synchrony Index.

Secondary

MeasureTime frameDescription
Change in heart rate, HR, (hemodynamic response) in relation to PK (PK/PD)Baseline until 12 hours after stop of infusionHR will be monitored 1/second according to clinical routine in the neonatal intensive care, and concomitantly downloaded into the aEEG (amplitude integrated electroencephalography) monitor. The change will be described as percentage increase/decrease. The change from baseline response in heart rate using longitudinal models of data on these endpoints following dexmedetomidine administration using a population PK/PD approach.
Change in mean arterial blood pressure, MABP, (hemodynamic response) in relation to PK (PK/PD)Baseline until 12 hours after stop of infusionMABP will be monitored 1/second according to clinical routine in the neonatal intensive care, and concomitantly downloaded into the aEEG (amplitude integrated electroencephalography) monitor. The change will be described as percentage increase/decrease. The change from baseline response in MABP using longitudinal models of data on these endpoints following dexmedetomidine administration using a population PK/PD approach.
Change in/association between Near Infrared spectroscopy, NIRS, in relation to PK.Once per second (from baseline until 12 hours after stop of infusion)NIRS will be monitored 1/second according to clinical routine in the neonatal intensive care, and concomitantly downloaded into the aEEG (amplitude integrated electroencephalography) monitor. The change will be described as percentage increase/decrease
Procedural pain response in relation to PK: assessed with change in galvanic skin responseOnce during treatment with dexmedetomidineProcedural pain response at a short standardized pain stimulation;

Countries

Sweden

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026