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Loxapine to control agitation during weaning from mechanical ventilation
BACKGROUND: Weaning from mechanical ventilation (MV) may be impeded by the occurrence of agitation. Loxapine has the ability to control agitation without affecting spontaneous ventilation. The aim of this study was to establish whether loxapine would reduce MV weaning duration in agitated patients....
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586048/ https://www.ncbi.nlm.nih.gov/pubmed/28877705 http://dx.doi.org/10.1186/s13054-017-1822-y |
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author | Gaudry, Stéphane Sztrymf, Benjamin Sonneville, Romain Megarbane, Bruno Van Der Meersch, Guillaume Vodovar, Dominique Cohen, Yves Ricard, Jean-Damien Hajage, David Salomon, Laurence Dreyfuss, Didier |
author_facet | Gaudry, Stéphane Sztrymf, Benjamin Sonneville, Romain Megarbane, Bruno Van Der Meersch, Guillaume Vodovar, Dominique Cohen, Yves Ricard, Jean-Damien Hajage, David Salomon, Laurence Dreyfuss, Didier |
author_sort | Gaudry, Stéphane |
collection | PubMed |
description | BACKGROUND: Weaning from mechanical ventilation (MV) may be impeded by the occurrence of agitation. Loxapine has the ability to control agitation without affecting spontaneous ventilation. The aim of this study was to establish whether loxapine would reduce MV weaning duration in agitated patients. METHODS: We performed a multicentre, double-blind, placebo-controlled, parallel group, randomised trial. Patients who were potential candidates for weaning but exhibited agitation (Richmond Agitation-Sedation Scale score ≥ 2) after sedation withdrawal were randomly assigned to receive either loxapine or placebo. In case of severe agitation, conventional sedation was immediately resumed. The primary endpoint was the time between first administration of loxapine or placebo and successful extubation. RESULTS: The trial was discontinued after 102 patients were enrolled because of an insufficient inclusion rate. Median times to successful extubation were 3.2 days in the loxapine group and 5 days in the placebo group (relative risk 1.2, 95% CI 0.75–1.88, p = 0.45). During the first 24 h, sedation was more frequently resumed in the placebo group (44% vs 17%, p = 0.01). CONCLUSIONS: In this prematurely stopped trial, loxapine did not significantly shorten weaning from MV. However, loxapine reduced the need for resuming sedation. TRIAL REGISTRATION: Clinicaltrials.gov, NCT01193816. Registered on 26 August 2010. |
format | Online Article Text |
id | pubmed-5586048 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-55860482017-09-06 Loxapine to control agitation during weaning from mechanical ventilation Gaudry, Stéphane Sztrymf, Benjamin Sonneville, Romain Megarbane, Bruno Van Der Meersch, Guillaume Vodovar, Dominique Cohen, Yves Ricard, Jean-Damien Hajage, David Salomon, Laurence Dreyfuss, Didier Crit Care Research BACKGROUND: Weaning from mechanical ventilation (MV) may be impeded by the occurrence of agitation. Loxapine has the ability to control agitation without affecting spontaneous ventilation. The aim of this study was to establish whether loxapine would reduce MV weaning duration in agitated patients. METHODS: We performed a multicentre, double-blind, placebo-controlled, parallel group, randomised trial. Patients who were potential candidates for weaning but exhibited agitation (Richmond Agitation-Sedation Scale score ≥ 2) after sedation withdrawal were randomly assigned to receive either loxapine or placebo. In case of severe agitation, conventional sedation was immediately resumed. The primary endpoint was the time between first administration of loxapine or placebo and successful extubation. RESULTS: The trial was discontinued after 102 patients were enrolled because of an insufficient inclusion rate. Median times to successful extubation were 3.2 days in the loxapine group and 5 days in the placebo group (relative risk 1.2, 95% CI 0.75–1.88, p = 0.45). During the first 24 h, sedation was more frequently resumed in the placebo group (44% vs 17%, p = 0.01). CONCLUSIONS: In this prematurely stopped trial, loxapine did not significantly shorten weaning from MV. However, loxapine reduced the need for resuming sedation. TRIAL REGISTRATION: Clinicaltrials.gov, NCT01193816. Registered on 26 August 2010. BioMed Central 2017-09-06 /pmc/articles/PMC5586048/ /pubmed/28877705 http://dx.doi.org/10.1186/s13054-017-1822-y Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Gaudry, Stéphane Sztrymf, Benjamin Sonneville, Romain Megarbane, Bruno Van Der Meersch, Guillaume Vodovar, Dominique Cohen, Yves Ricard, Jean-Damien Hajage, David Salomon, Laurence Dreyfuss, Didier Loxapine to control agitation during weaning from mechanical ventilation |
title | Loxapine to control agitation during weaning from mechanical ventilation |
title_full | Loxapine to control agitation during weaning from mechanical ventilation |
title_fullStr | Loxapine to control agitation during weaning from mechanical ventilation |
title_full_unstemmed | Loxapine to control agitation during weaning from mechanical ventilation |
title_short | Loxapine to control agitation during weaning from mechanical ventilation |
title_sort | loxapine to control agitation during weaning from mechanical ventilation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586048/ https://www.ncbi.nlm.nih.gov/pubmed/28877705 http://dx.doi.org/10.1186/s13054-017-1822-y |
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