NCT06192615

Brief Summary

This is a pragmatic phase III, randomized, blinded, double placebo-controlled, three-arm trial of elderly patients following cardiac surgery to assess the relationship between nighttime intravenous (IV) and sublingual dexmedetomidine on postoperative delirium and functional outcomes after surgery.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,800

participants targeted

Target at P75+ for phase_3

Timeline
36mo left

Started Jan 2025

Typical duration for phase_3

Geographic Reach
1 country

14 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress32%
Jan 2025Mar 2029

First Submitted

Initial submission to the registry

December 21, 2023

Completed
15 days until next milestone

First Posted

Study publicly available on registry

January 5, 2024

Completed
1 year until next milestone

Study Start

First participant enrolled

January 6, 2025

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 31, 2027

Expected
1.4 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 31, 2029

Last Updated

December 31, 2025

Status Verified

January 1, 2025

Enrollment Period

2.8 years

First QC Date

December 21, 2023

Last Update Submit

December 29, 2025

Conditions

Outcome Measures

Primary Outcomes (1)

  • Delirium

    The primary outcome will be delirium occurring on postoperative day one. Delirium will be assessed using the Confusion Assessment Method (CAM) twice daily. Delirium will be defined as present if either the morning or afternoon assessment are positive for delirium.

    Postoperative day 1

Secondary Outcomes (11)

  • Delirium

    Postoperative Day 1 to Day 7

  • Delirium Severity

    Postoperative day 1 to day 7

  • Telephonic Montreal Cognitive Assessment

    30, 180 and 365 days

  • Global Health

    30, 180 and 365 days

  • Pain at Rest and Upon Exertion

    Postoperative day 1 to day 7

  • +6 more secondary outcomes

Study Arms (3)

Intravenous Dexmedetomidine

EXPERIMENTAL

After admission to the ICU and discontinuation of mechanical ventilation, intravenous dexmedetomidine (1 μg/kg over 40 minutes, a maximal dose of 80 μg) and a sublingual placebo (inert film) will be administered nightly for the first three nights while the patient is in the intensive care unit.

Drug: Intravenous DexmedetomidineDrug: Sublingual Placebo

Sublingual Dexmedetomidine

EXPERIMENTAL

After admission to the ICU and discontinuation of mechanical ventilation, sublingual dexmedetomidine (120 μg) and an intravenous placebo (0.9% saline over 40 minutes) will be administered nightly for the first three nights while the patient is in the intensive care unit.

Drug: Sublingual DexmedetomidineDrug: Intravenous Placebo

Placebo

PLACEBO COMPARATOR

After admission to the ICU and discontinuation of mechanical ventilation, an intravenous placebo (0.9% saline over 40 minutes) and a sublingual placebo (inert film) will be administered nightly for the first three nights while the patient is in the intensive care unit.

Drug: Intravenous PlaceboDrug: Sublingual Placebo

Interventions

Intravenous dexmedetomidine (1 μg/kg over 40 minutes, a maximal dose of 80 μg)

Also known as: Intravenous Precedex
Intravenous Dexmedetomidine

Sublingual dexmedetomidine (120 μg)

Also known as: Sublingual Precedex
Sublingual Dexmedetomidine

Intravenous placebo of 0.9% saline administered over 40 minutes

Also known as: Placebo
PlaceboSublingual Dexmedetomidine

Inert sublingual film

Also known as: Placebo
Intravenous DexmedetomidinePlacebo

Eligibility Criteria

Age60 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Aged 60 years or older
  • Scheduled to undergo a cardiac surgical procedure with cardiopulmonary bypass
  • Planned postoperative admission to the intensive care unit (ICU)

You may not qualify if:

  • Allergy or hypersensitivity to dexmedetomidine or the placebo study medication
  • Preexisting diagnosis of Alzheimer's Disease or Related Dementia, severe cognitive impairment or delirium at baseline
  • Severe liver failure (Child-Pugh score \> 5)
  • Severe deficit(s) due to structural or anoxic brain damage
  • Undergoing a surgical procedure requiring total circulatory arrest
  • SARS-CoV-2 positive or symptomatic (e.g., fever, cough, loss of taste/smell)
  • Blind, deaf, or unable to communicate in English
  • Patients experiencing circumstances for which long-term follow-up might be difficult (e.g., homelessness, active psychotic disorder, or substance abuse)
  • Co-enrollment in other interventional studies that, in the opinion of the site investigator and/or PI, might interfere with study participation, collection, or interpretation of the study data

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (14)

Cedars-Sinai Medical Center

Los Angeles, California, 90048, United States

NOT YET RECRUITING

University of California San Francisco

San Francisco, California, 94117, United States

NOT YET RECRUITING

Northwestern University Feinberg School of Medicine

Chicago, Illinois, 60611, United States

RECRUITING

University of Iowa Carver College of Medicine

Iowa City, Iowa, 522421320, United States

RECRUITING

University of Maryland School of Medicine

Baltimore, Maryland, 21201, United States

RECRUITING

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

RECRUITING

Beth Israel Deaconess Medical Center

Boston, Massachusetts, 02215, United States

RECRUITING

Brigham and Women's Hospital

Boston, Massachusetts, 02215, United States

RECRUITING

Washington University School of Medicine

St Louis, Missouri, 63110, United States

NOT YET RECRUITING

University of Nebraska Medical Center

Omaha, Nebraska, 68198, United States

RECRUITING

Columbia University Medical Center

New York, New York, 10032, United States

RECRUITING

Montefiore Medical Center

The Bronx, New York, 10467, United States

NOT YET RECRUITING

Duke University Hospital

Durham, North Carolina, 27710, United States

RECRUITING

Vanderbilt University Medical Center

Nashville, Tennessee, 37232, United States

RECRUITING

MeSH Terms

Conditions

Delirium

Condition Hierarchy (Ancestors)

ConfusionNeurobehavioral ManifestationsNeurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and SymptomsNeurocognitive DisordersMental Disorders

Study Officials

  • Oluwaseun Johnson-Akeju, MD

    Massachusetts General Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Oluwaseun Johnson-Akeju, MD

CONTACT

Ariel Mueller, MA

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Anesthetist-in-Chief

Study Record Dates

First Submitted

December 21, 2023

First Posted

January 5, 2024

Study Start

January 6, 2025

Primary Completion (Estimated)

October 31, 2027

Study Completion (Estimated)

March 31, 2029

Last Updated

December 31, 2025

Record last verified: 2025-01

Data Sharing

IPD Sharing
Will share
Shared Documents
STUDY PROTOCOL, SAP, ICF

Locations