Actively Recruiting

Phase Not Applicable
Age: 20Weeks - 45Weeks
All Genders
ID05371886

Pharmacokinetics-pharmacodynamics of Morphine With or Without Midazolam Administered by Continuous Infusion in Neonatal Intensive Care

Led by Centre Hospitalier Intercommunal Creteil · Updated on 2025-11-17

180

Participants Needed

5

Research Sites

200 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are studying how morphine alone and morphine combined with midazolam, given as a continuous infusion, affect newborns in neonatal intensive care units (NICUs) who require mechanical ventilation. The study aims to understand the relationship between drug dose, concentration in the body, and the resulting effect, including comfort and pain levels in these neonates. This research uses pharmacokinetic-pharmacodynamic (PKPD) modeling to describe these relationships and account for differences between individual babies based on factors like gestational age, post-natal age, and weight. The study includes neonates receiving continuous infusions of morphine alone or with midazolam during mechanical ventilation in three French NICUs. Comfort and pain are assessed using the COMFORTneo pain score and Newborn Infant Parasympathetic Evaluation (NIPE) Index. Blood samples taken during routine testing will measure morphine, midazolam, and their metabolites concentrations. Using PKPD modeling, researchers will analyze dose-effect and dose-concentration relationships and simulate the doses needed to maintain comfort in neonates. During the study, participants will have their pain and comfort levels regularly assessed while receiving morphine or morphine plus midazolam infusions for up to 20 weeks. Blood samples from planned tests will be analyzed for drug levels. The primary outcome is the effective dose for 50% of neonates (ED50) receiving morphine. Secondary outcomes include drug clearance, distribution volume, concentrations, dosing rates, and pain responses by the NIPE index. The study monitors these outcomes from inclusion until the end of treatment, helping to better understand dosing needs and effects in this vulnerable population.

CONDITIONS

Brief Title

Pharmacokinetics-pharmacodynamics of Morphine With or Without Midazolam Administered by Continuous Infusion in Neonatal Intensive Care

Who Can Participate

Age: 20Weeks - 45Weeks
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Neonates younger than 45 weeks of corrected gestational age
  • Hospitalized in a Neonatal Intensive Care Unit
  • Undergoing mechanical ventilation
  • Receiving morphine alone or morphine and midazolam as continuous infusion
  • Affiliated to a social security system
Not Eligible

You will not qualify if you...

  • Current weight less than 600 grams
  • Neonates under palliative care
  • Receiving therapeutic hypothermia for perinatal anoxia
  • Neonates who had surgery within the past 72 hours
  • Receiving paralytic or other sedation/analgesia drugs besides morphine or midazolam (except paracetamol/acetaminophen)
  • Parents refusing their child to participate

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - From date of inclusion until the end of morphine +/- midazolam treatment, up to 20 weeks

Participants receive continuous infusion of morphine alone or morphine with midazolam during mechanical ventilation in the neonatal intensive care unit. Pain and comfort are assessed while drug concentrations are measured through planned blood tests.

Visits occur as needed for continuous infusion and planned blood sampling during treatment

Trial Site Locations

Total: 5 locations

1

CHRU Morvan

Brest, France, 29609

Actively Recruiting

2

CH SUD Francilien

Corbeil-Essonnes, France, 91100

Actively Recruiting

3

CHI Créteil

Créteil, France, 94000

Actively Recruiting

4

CHU Lille

Lille, France

Actively Recruiting

5

CHU Tours

Tours, France

Actively Recruiting

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Research Team

M

Manon TAUZIN, MD

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

NA

Model

SINGLE_GROUP

Primary Purpose

SUPPORTIVE_CARE

Number of Arms

1

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