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Trial registered on ANZCTR
Registration number
ACTRN12606000141549
Ethics application status
Approved
Date submitted
16/04/2006
Date registered
24/04/2006
Date last updated
19/08/2008
Type of registration
Retrospectively registered
Titles & IDs
Public title
The impact of Bispectral Index monitoring on sedation administration in mechanically ventilated patients
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Scientific title
The impact of Bispectral Index monitoring on sedation administration in mechanically ventilated patients
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Mechanically ventilated intensive care unit (ICU) patients receiving sedative drug infusions
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Condition category
Condition code
Other
1190
1190
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0
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Research that is not of generic health relevance and not applicable to specific health categories listed above
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study is designed as a prospective randomised control trial with parallel design. Participants randomised to the intervention group will receive bispectral index sedation (BIS) monitoring.
The bispectral index sedation monitor is derived from the electroencephalogram and provides a numeric value that represents cerebral activity. Nurses will be able to titrate and manage sedation based on an objective score (0- 100) that reflects the patients level of sedation. Patients randomised to recieve BIS monitoring will be continously monitored until they are extubated or a tracheostomy is performed. Patients randomised to the control intervention will recieve standard care and their sedative needs will be assessed and managed based on subjective sedation assessments. The control arm will continue until sedatives are no longer required.
Data collection will cease for all patients at the time of extubation or tracheostomy.
Both groups of participants will be managed by nurses with a range of general nursing and critical care nursing experience, and with differing levels of critical care training.
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Intervention code [1]
985
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Treatment: Devices
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Comparator / control treatment
The control group will receive the standard Alfred Hospital intensive care unit sedation assessment and management. The control arm will continue until sedatives are no longer required.
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary outcome measure will be mean sedation for each nursing shift
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Assessment method [1]
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Timepoint [1]
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Mean sedation will be calculated at the end of each nursing shift. This will allow multiple data collection points per participant and repeated measures analysis.
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Secondary outcome [1]
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Days of mechanical ventilation
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Assessment method [1]
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Timepoint [1]
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Days. Measured at discharge from ICU.
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Secondary outcome [2]
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Length of ICU stay (days)
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Assessment method [2]
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Timepoint [2]
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Days. Measured at discharge from the ICU.
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Eligibility
Key inclusion criteria
Intubated and mechanically ventilatedLikely to be ventilated for at least 12 hoursReceiving sedative infusion of morphine and midazolam.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Intracranial injury, neurological disorders, status epilepticus, facial burns.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation was concealed by using sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be undertaken using a computer generated random number list
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
14/09/2004
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
50
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Australian College Critical Care Nursing
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Address [1]
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PO Box 219
South Carlton
VICT 3053
Australia
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Alfred Hospital
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Address
89 Commercial Road
Melbourne
VIC 3004
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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LaTrobe Universtity
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Address [1]
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Latrobe University (Bundora)
VICTORIA , 3086
Australia
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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22/07/2004
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Ethics approval number [1]
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111/04
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Summary
Brief summary
This study is designed to assess the effectiveness of the Bispectral Index (BIS) monitor in helping nurses to decide if intensive care patient’s are receiving the right amount of sedation medication to keep them comfortable and asleep while they are connected to the ventilator. The BIS monitor is a non-invasive machine that measures electrical brain wave activity, and converts it into a number that indicates if patients are too awake or deeply unresponsive. The study will be conducted in the Intensive Care Unit at the Alfred Hospital. This study is designed as a prospective randomised control trial with parallel design. This means that participants’ will be randomly allocated into either one of two groups – an intervention or control group. Participant’s randomised to the intervention group will receive BIS monitoring. The control group will receive standard ICU sedation assessment and management. To determine if BIS monitoring is useful in ICU, information will be collected by auditing patient charts and determining the average amounts of sedation medication for each nursing shift. In addition, the years of critical care experience and critical care qualification will be recorded for each nurse managing patients recruited to the study.
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Trial website
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Trial related presentations / publications
Anaesthesia and Intensive Care 2007; 35: 204-208
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Cindy Weatherburn
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Address
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Alfred Hospital
89 Commercial Road
Melbourne VIC 3004
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Country
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Australia
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Phone
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61 3 90768801
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Fax
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61 3 90762343
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Email
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[email protected]
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Contact person for scientific queries
Name
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Cindy Weatherburn
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Address
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Alfred Hospital
89 Commercial Road
Melbourne VIC 3004
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Country
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Australia
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Phone
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61 3 90768801
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Fax
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61 3 90762343
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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