瑞马唑仑与咪达唑仑对ARDS机械通气患者呼吸力学的影响-一项多中心随机对照临床研究

注册号:

Registration number:

ChiCTR2500114421 

最近更新日期:

Date of Last Refreshed on:

2025-12-11 15:25:54 

注册时间:

Date of Registration:

2025-12-11 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

瑞马唑仑与咪达唑仑对ARDS机械通气患者呼吸力学的影响-一项多中心随机对照临床研究

Public title:

Remimazolam versus Midazolam for Respiratory Mechanics in ARDS Patients Requiring Mechanical Ventilation: A Multicenter Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

瑞马唑仑与咪达唑仑对ARDS机械通气患者呼吸力学的影响-一项多中心随机对照临床研究

Scientific title:

Remimazolam versus Midazolam for Respiratory Mechanics in ARDS Patients Requiring Mechanical Ventilation: A Multicenter Randomized Controlled Trial

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

张媛莉 

研究负责人:

张媛莉 

Applicant:

Zhang Yuanli 

Study leader:

Zhang Yuanli 

申请注册联系人电话:

Applicant telephone:

+86 138 2822 3316

研究负责人电话:

Study leader's
telephone:

+86 138 2822 3316

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

zhangyuanly@126.com

研究负责人电子邮件:

Study leader's E-mail:

zhangyuanly@126.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

广东省湛江市霞山区人民大道南57号

研究负责人通讯地址:

广东省湛江市霞山区人民大道南57号

Applicant address:

No. 57 Renmin Avenue South, Xiashan District, Zhanjiang, Guangdong, China

Study leader's address:

No. 57 Renmin Avenue South, Xiashan District, Zhanjiang, Guangdong, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

广东医科大学附属医院

Applicant's institution:

Affiliated Hospital of Guangdong Medical University

研究负责人所在单位:

广东医科大学附属医院

Affiliation of the Leader:

Affiliated Hospital of Guangdong Medical University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

PJKT2024-198-02; PJKT2024-198-03

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

广东医科大学附属医院临床科研伦理委员会

Name of the ethic committee:

Clinical Research Ethics Committee of the Affiliated Hospital of Guangdong Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2024-11-04 00:00:00

伦理委员会联系人:

陈敏,李宛珊

Contact Name of the ethic committee:

Chen Min, Li Wanshan

伦理委员会联系地址:

广东省湛江市人民大道南 57 号

Contact Address of the ethic committee:

No. 57 Renmin Avenue South, Xiashan District, Zhanjiang, Guangdong, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 759 238 6971

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

广东医科大学附属医院

Primary sponsor:

Affiliated Hospital of Guangdong Medical University

研究实施负责(组长)单位地址:

广东省湛江市霞山区人民大道南57号

Primary sponsor's address:

No. 57 Renmin Avenue South, Xiashan District, Zhanjiang, Guangdong, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

广东省

市(区县):

湛江市

Country:

China

Province:

Guangdong

City:

Zhanjiang

单位(医院):

广东医科大学附属医院

具体地址:

广东省湛江市霞山区人民大道南57号

Institution
hospital:

Affiliated Hospital of Guangdong Medical University

Address:

No. 57 Renmin Avenue South, Xiashan District, Zhanjiang, Guangdong, China

经费或物资来源:

国家卫生健康委医药卫生科技发展研究中心

Source(s) of funding:

Development Center for Medical Science & Technology National Health Commission of the People's Republic of China

研究疾病:

急性肺损伤和急性呼吸窘迫综合征  

Target disease:

Acute Lung Injury and Acute Respiratory Distress Syndrome

研究疾病代码:

CA45

Target disease code:

CA45

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

上市后药物 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

旨在确定瑞马唑仑与咪达唑仑对 ARDS 机械通气患者无机械通气时间和呼吸力学的影响,为ARDS的防治提供理论依据。  

Objectives of Study:

The aim is to determine the effects of remimazolam versus midazolam on ventilator-free time and respiratory mechanics in ARDS patients undergoing mechanical ventilation, thereby providing a theoretical basis for the prevention and treatment of ARDS.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.孕妇及哺乳期妇女; 2.对瑞马唑仑、咪达唑仑、舒芬太尼、瑞芬太尼过敏; 3.恶性肿瘤患者; 4.最近 3 个月参加过其他临床试验; 5.预计 48 小时内死亡者; 6.急慢性严重神经肌肉疾病和任何其他干扰 RASS 评估的病症; 7.急性肝炎或严重肝功能障碍(Child-Pugh C 级); 8.慢性肾脏病,肾小球滤过率(GFR) < 60 ml/min/1.73m^2; 9.左心室射血分数小于 30%; 10.MAP 下降超过基线的 25%或收缩压(SBP)<80mmHg,间断给予升压药>2 次或需连续给予多巴胺>3ug/kg/h 处理无效者: 11.严重 ARDS 需要 ECMO 支持治疗; 12.慢性纤维化及严重肺功能障碍患者;

Exclusion criteria:

1. Pregnant or lactating women. 2. Known hypersensitivity to remimazolam, midazolam, sufentanil, or remifentanil. 3. Active malignancy. 4. Participation in another clinical trial within the preceding 3 months. 5. Death expected within 48 hours. 6. Severe acute or chronic neuromuscular disease, or any condition that precludes reliable RASS assessment. 7. Acute hepatitis or severe hepatic dysfunction (Child-Pugh class C). 8. Chronic kidney disease with eGFR < 60 mL/min/1.73 m². 9. Left ventricular ejection fraction < 30 %. 10. MAP decrease > 25 % from baseline OR SBP < 80 mmHg despite ≥2 boluses of vasopressors OR continuous dopamine > 3 µg/kg/h without response. 11. Severe ARDS requiring ECMO support. 12. Advanced pulmonary fibrosis or other irreversible severe lung disease.

研究实施时间:

Study execute time:

From 2025-01-01 00:00:00 To 2027-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-10-24 00:00:00 To 2027-12-31 00:00:00

干预措施:

Interventions:

组别:

咪达唑仑组

样本量:

167

Group:

Midazolam group

Sample size:

干预措施:

生理盐水 24ml+咪达唑仑 30mg 静脉泵入 (0.02-0.1mg/kg/h,必要时给予负荷剂量 0.01-0.05mg/kg),生理盐水47ml+枸橼酸舒芬太尼注射液 150ug 静脉泵入 ( 0.2-0.3ug/kg/h, 必要时给予负荷剂 0.2-0.5mg/kg) 或 者 生理盐水 50ml+ 注射用盐酸瑞芬太尼 2mg 静脉泵入(0.2-0.15ug/kg/min,必要时给予负荷剂量 0.5-1.0mg/kg)。

干预措施代码:

Intervention:

24 mL normal saline + 30 mg midazolam administered by intravenous infusion (0.02–0.1 mg/kg/h; a loading dose of 0.01–0.05 mg/kg may be given if required), together with either: 47 mL normal saline + 150 μg sufentanil citrate injection by intravenous infusion (0.2–0.3 μg/kg/h; loading dose 0.2–0.5 μg/kg if required), OR 50 mL normal saline + 2 mg remifentanil hydrochloride for injection by intravenous infusion (0.15–0.2 μg/kg/min; loading dose 0.5–1.0 μg/kg if required).

Intervention code:

组别:

瑞马唑仑组

样本量:

167

Group:

Remimazolam group

Sample size:

干预措施:

生理盐水 50ml+瑞马唑仑 72mg静脉泵入 (0.1-0.4mg/kg/h ,必要时给予负荷剂量 0.1-0.2mg/kg),生理盐水47ml+枸橼酸舒芬太尼注射液 150ug 静脉泵入 ( 0.2-0.3ug/kg/h, 必要时给予负荷剂 0.2-0.5mg/kg) 或 者 生理盐水 50ml+ 注射用盐酸瑞芬太尼 2mg 静脉泵入(0.2-0.15ug/kg/min,必要时给予负荷剂量 0.5-1.0mg/kg)。

干预措施代码:

Intervention:

50 mL normal saline + 72 mg remimazolam administered by intravenous infusion (0.1–0.4 mg/kg/h; a loading dose of 0.1–0.2 mg/kg may be given if required), together with either: 47 mL normal saline + 150 μg sufentanil citrate injection by intravenous infusion (0.2–0.3 μg/kg/h; loading dose 0.2–0.5 μg/kg if required), OR 50 mL normal saline + 2 mg remifentanil hydrochloride for injection by intravenous infusion (0.15–0.2 μg/kg/min; loading dose 0.5–1.0 μg/kg if required).

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

广东省 

市(区县):

湛江市 

Country:

China

Province:

Guangdong

City:

Zhanjiang

单位(医院):

广东医科大学附属医院 

单位级别:

三甲 

Institution
hospital:

Affiliated Hospital of GuangDong Medicine University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东省 

市(区县):

湛江市 

Country:

China

Province:

Guangdong

City:

Zhanjiang

单位(医院):

广东医科大学附属第二医院 

单位级别:

三甲 

Institution
hospital:

The Second Affiliated Hospital of Guangdong Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东省 

市(区县):

湛江市 

Country:

China

Province:

Guangdong

City:

Zhanjiang

单位(医院):

遂溪县人民医院 

单位级别:

二级 

Institution
hospital:

Suixi County People's Hospital

Level of the institution:

Secondary

测量指标:

Outcomes:

指标中文名:

评估 7 天及 28 天内无机械通气时间

指标类型:

主要指标

Outcome:

Evaluate the number of ventilator-free days at days 7 and 28.

Type:

Primary indicator

测量时间点:

入组后第7天及第28天

测量方法:

Measure time point of outcome:

From the 7th to the 28th day after inclusion

Measure method:

指标中文名:

28 天死亡率

指标类型:

次要指标

Outcome:

28-day mortality

Type:

Secondary indicator

测量时间点:

入组后第28天

测量方法:

Measure time point of outcome:

"Day 28 after enrollment"

Measure method:

指标中文名:

两组镇静镇痛治疗后平台压、驱动压、静态顺应性、气道阻力、PEEPi、P0.1

指标类型:

次要指标

Outcome:

Plateau pressure, driving pressure, static compliance, airway resistance, PEEPi, and P0.1 after sedoanalgesia in both groups.

Type:

Secondary indicator

测量时间点:

纳入后第7天至第28天

测量方法:

Measure time point of outcome:

From the 7th to the 28th day after inclusion

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

伤口分泌物

组织:

Sample Name:

Wound exudate

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age -- years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

由分组负责人使用SPSS进行简单随机分组

Randomization Procedure (please state who generates the random number sequence and by what method):

Simple randomization will be performed by the group principal using SPSS.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

none

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

计划公开日期:2028年3月1日 共享方式:通过联系研究者获取原始数据查看权限,网址:https://docs.qq.com/sheet/DTnVBY1FMRGZ5cXFQ。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Planned public release date: March 1, 2028 Sharing method: Permission to view the raw data will be granted upon request to the investigators.Web:https://docs.qq.com/sheet/DTnVBY1FMRGZ5cXFQ.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录法

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Record Form, CRF

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2025-12-11 15:25:36