Actively Recruiting

Phase 3
Age: 44Weeks - 11Years
All Genders
NCT04801589

Goal-Directed Sedation in Mechanically Ventilated Infants and Children

Led by Vanderbilt University Medical Center · Updated on 2025-09-29

372

Participants Needed

1

Research Sites

279 weeks

Total Duration

On this page

Sponsors

V

Vanderbilt University Medical Center

Lead Sponsor

P

Pfizer

Collaborating Sponsor

AI-Summary

What this Trial Is About

Ventilated pediatric patients are frequently over-sedated and the majority suffer from delirium, a form of acute brain dysfunction that is an independent predictor of increased risk of dying, length of stay, and costs. Universally prescribed sedative medications-the GABA-ergic benzodiazepines-worsen this brain organ dysfunction and independently prolong duration of ventilation and ICU stay, and the available alternative sedation regimen using dexmedetomidine, an alpha-2 agonist, has been shown to be superior to benzodiazepines in adults, and may mechanistically impact outcomes through positive effects on innate immunity, bacterial clearance, apoptosis, cognition and delirium. The mini-MENDS trial will compare dexmedetomidine and midazolam, and determine the best sedative medication to reduce delirium and improve duration of ventilation, and functional, psychiatric, and cognitive recovery in our most vulnerable patients-survivors of pediatric critical illness.

CONDITIONS

Official Title

Goal-Directed Sedation in Mechanically Ventilated Infants and Children

Who Can Participate

Age: 44Weeks - 11Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Patients aged between 44 weeks post-menstrual age and 11 years
  • Planned admission to the pediatric ICU at Monroe Carell Jr. Children's Hospital at Vanderbilt
  • Require mechanical ventilation and sedation
Not Eligible

You will not qualify if you...

  • Receiving continuous sedation for more than 72 hours before screening
  • Rapidly resolving respiratory failure with planned immediate liberation from mechanical ventilation
  • Severe developmental delay defined as a score of 4 or higher on the Pediatric Cerebral Performance Category Scale
  • Clinically significant 2nd or 3rd degree heart block or bradycardia below 60 beats per minute
  • Benzodiazepine dependency requiring ongoing continuous infusion
  • Inability to co-enroll with another study
  • Expected death or planned withdrawal of support within 24 hours of enrollment
  • Bilateral vision loss
  • Deafness preventing delirium evaluation
  • Inability to understand English that prevents delirium evaluation unless translation services are available
  • Documented allergy to dexmedetomidine or midazolam
  • Need for continuous neuromuscular blockade infusion planned for at least 48 hours at screening
  • Inability to start informed consent within 72 hours of meeting all inclusion criteria
  • Adjusted dosing weight over 50 kg at screening

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Trial Site Locations

Total: 1 location

1

Vanderbilt University Medical Center

Nashville, Tennessee, United States, 37232

Actively Recruiting

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Research Team

H

Heidi Smith, MD, MSCI

CONTACT

R

Rebecca Abel, MA

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

QUADRUPLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

PREVENTION

Number of Arms

2

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