Delirium Clinical Trial
Official title:
Feasibility of Melatonin for Prevention of Delirium in Critically Ill Patients: a Multi-centre, Randomized, Placebo-controlled Study.
The purpose of this study is to determine the feasibility of conducting a randomized controlled trial (RCT) with melatonin for prevention of delirium in critically ill adult patients. The investigators hypothesize that melatonin, administered on a scheduled nightly basis during ICU admission, will be efficacious and safe for the prevention of delirium in critically ill adults.
The available evidence indicates melatonin may decrease the incidence of delirium in
non-critically ill patient populations; however, trials in the critically ill are lacking.
The investigators hypothesize that melatonin, administered on a scheduled nightly basis
during ICU admission, will be efficacious and safe for the prevention of delirium in
critically ill adults. The null hypothesis is that there is no difference in delirium
incidence between placebo and melatonin. Prior to conducting an adequately powered
multi-centre, blinded randomized, placebo-controlled trial in critically ill patients, there
is a need for a better understanding of melatonin pharmacokinetics (PK) in critically ill
patients. This will help to determine appropriate dosing, drug administration issues
(specifically protocol adherence), adverse drug effects, and recruitment rates based on
inclusion and exclusion criteria.
The specific aim is to conduct a phase II triple blind, placebo-controlled randomized trial
comparing two doses of melatonin (low dose = 0.5 mg and high dose = 2.0 mg) to assess the
feasibility of a future full-scale RCT. Feasibility of the larger trial will be based on
protocol adherence and participant recruitment rates. Data on PK properties of melatonin will
be assessed to determine dosing for future studies of melatonin for delirium prevention in
the critically ill.
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