• Rameela Chandrasekhar, Christopher G Hughes, Brenda T Pun, Onur M Orun, E Wesley Ely, and Pratik P Pandharipande.
• Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, TN, USA. rameela.chandrasekhar@vanderbilt.edu.
• Crit Care Resusc. 2020 Mar 1; 22 (1): 637163-71.

BackgroundThe best sedative medication to reduce delirium, mortality and long term brain dysfunction in mechanically ventilated septic patients is unclear. This multicentre, double-blind, randomised trial investigates the short term and long term effects of dexmedetomidine versus propofol for sedation in mechanically ventilated severely septic patients.ObjectivesTo describe the statistical analysis plan for this randomised clinical trial comprehensively and place it in the public domain before unblinding.MethodsTo ensure that analyses are not selectively reported, we developed a comprehensive statistical analysis plan before unblinding. This trial has an enrolment target of 420 severely septic and mechanically ventilated adult patients, randomly assigned to dexmedetomidine or propofol in a 1:1 ratio. Enrolment was completed in January 2019, and the study was estimated to be completed in September 2019. The primary endpoint is days alive without delirium or coma during first 14 study days. Secondary outcomes include 28-day ventilator-free days, 90-day all-cause mortality and cognitive function at 180 days. Time frames all begin on the day of randomisation. All analyses will be conducted on an intention-to-treat basis.ConclusionThis study will compare the effects of two sedatives in mechanically ventilated severely septic patients. In keeping with the guidance on statistical principles for clinical trials, we have developed a comprehensive statistical analysis plan by which we will adhere, as this will avoid bias and support transparency and reproducibility.Trial RegistrationClinicalTrials.gov (NCT01739933).

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