Effect of Enteral Nutrition Enriched in Protein and Based on Indirect Calorimetry Measurement in Chronically Critically Ill Patients

NCT ID: NCT01142570

Last Updated: 2010-10-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-09-30

Study Completion Date

2012-11-30

Brief Summary

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This is a single-center, prospective, randomized, comparative, double-blind controlled clinical study intended to establish 1) the optimal method of determining calorie requirements and 2) the optimal amount of protein supply in chronically ventilated patients.

Detailed Description

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The study will be performed in a chronic ventilation department.

Enrolled patients will be randomly allocated to receive calories as dictated by:

The Harriss-Benedict formula (Group 1) or Indirect Calorimetry (Group 2)

After one week of admission to the hospital department and study enrollment we will review the first results of the study.

After seven days of hospitalization and study enrollment patients who have not been weaned from the ventilator, will be divided into three groups.

1. Patients in the first group will receive caloric support calculated by the HARRISS BENEDICT equation and protein dose of 1.1 to 1.5 grams per kilogram weight.
2. Patients in the second group will receive caloric support as measured by indirect calorimetry and will receive protein at 1.1 grams per kilogram weight.
3. Patients in the third group will receive caloric support as measured by indirect calorimetry and will receive protein at a dose of 1.5 grams per kilogram weight.

Outcome of treatment results will be performed after one ,four and eight weeks:

1. Length of hospitalization
2. Weaning from Mechanical Ventilation
3. Development and progression of pressure ulcers
4. Infectious diseases incidence
5. Amount of insulin needed for glucose control
6. Length of mechanical ventilation
7. Readmission to Intensive Care Unit
8. Mortality rate

Conditions

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Critically Ill

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Group 1

Patients will be receive caloric support as dictated by Hariss-Benedict Formula (Group 1)

Group Type ACTIVE_COMPARATOR

Caloric Support (Group 1)

Intervention Type OTHER

Four group 1-dose of caloric support will be calculated by Hariss-Benedict Formula measurement of Resting Energy Expenditure(REE).

Group 2

Patients will be receive caloric support as dictated by Indirect Calorimetry (Group 2)

Group Type ACTIVE_COMPARATOR

Caloric Support (Group 2)

Intervention Type OTHER

For group 2- dose of caloric support will be calculated by Indirect Calorimetric measurement of Resting Energy Expenditure(REE)

Group 1A

After seven days of hospitalization and study enrollment patients who have not been weaned from ventilator, will be divided into three groups.

Patients in the first(Group 1A)group will receive caloric support calculated by the HARISS BENEDICT equation and protein dose of 1.1 to 1.5 grams per kilogram weight.

Group Type ACTIVE_COMPARATOR

Protein dose of 1.1 to 1.5 grams per kilogram weight.

Intervention Type DIETARY_SUPPLEMENT

Patients in the first group(Group 1A) will receive caloric support calculated by the HARRISS BENEDICT equation and protein dose of 1.1 to 1.5 grams per kilogram weight.

Group 2A

After seven days of hospitalization and study enrollment patients who have not been weaned from ventilator, will be divided into three groups.

Patients in the second group(Group 2A) will receive caloric support as measured by indirect calorimetry and will receive protein at 1.1 grams per kilogram weight.

Group Type ACTIVE_COMPARATOR

Protein at 1.1 grams per kilogram weight.

Intervention Type DIETARY_SUPPLEMENT

Patients in the second group(Group 2A) will receive caloric support as measured by indirect calorimetry and will receive protein at 1.1 grams per kilogram weight.

Group 3A

After seven days of hospitalization and study enrollment patients who have not been weaned from ventilator, will be divided into three groups.

Patients in the third group will receive caloric support as measured by indirect calorimetry and will receive protein at a dose of 1.5 grams per kilogram weight.

Group Type ACTIVE_COMPARATOR

protein at a dose of 1.5 grams per kilogram weight.

Intervention Type DIETARY_SUPPLEMENT

Patients in the third group (Group 3A) will receive caloric support as measured by indirect calorimetry and will receive protein at a dose of 1.5 grams per kilogram weight.

Interventions

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Caloric Support (Group 1)

Four group 1-dose of caloric support will be calculated by Hariss-Benedict Formula measurement of Resting Energy Expenditure(REE).

Intervention Type OTHER

Caloric Support (Group 2)

For group 2- dose of caloric support will be calculated by Indirect Calorimetric measurement of Resting Energy Expenditure(REE)

Intervention Type OTHER

Protein dose of 1.1 to 1.5 grams per kilogram weight.

Patients in the first group(Group 1A) will receive caloric support calculated by the HARRISS BENEDICT equation and protein dose of 1.1 to 1.5 grams per kilogram weight.

Intervention Type DIETARY_SUPPLEMENT

Protein at 1.1 grams per kilogram weight.

Patients in the second group(Group 2A) will receive caloric support as measured by indirect calorimetry and will receive protein at 1.1 grams per kilogram weight.

Intervention Type DIETARY_SUPPLEMENT

protein at a dose of 1.5 grams per kilogram weight.

Patients in the third group (Group 3A) will receive caloric support as measured by indirect calorimetry and will receive protein at a dose of 1.5 grams per kilogram weight.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Chronically Mechanical Ventilated Patients (more than 21 days of Mechanical Ventilation) by tracheostomy,
* Between ages 65-90

Exclusion Criteria

* Patient over age 90 and younger the age of 65
* PH level less than 7.3 due to metabolic causes.
* A patient with blood albumin level less than 2.2 g / dl
Minimum Eligible Age

65 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Beit Rivka Hospital

UNKNOWN

Sponsor Role collaborator

Rabin Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Beit Rivka Hospital , Geriatric medical center, Petah Tikva, Clalit Health Services

Principal Investigators

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Gregory Papirov, MD

Role: PRINCIPAL_INVESTIGATOR

Beit- Rivka Hospital, Petah-Tikva, Israel

Pierre Singer, MD, Professor

Role: STUDY_DIRECTOR

ICU, Rabin Medical Center,Petah- Tikva, Israel

Ludmila Zaidenberg, MD

Role: STUDY_DIRECTOR

Beit Rivka hospital, Petah- Tikva, Israel

Milana Grinev, RN,Study Coordinator

Role: STUDY_DIRECTOR

ICU, Rabin Medical Center,Petah- Tikva, Israel

Other Identifiers

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5668

Identifier Type: -

Identifier Source: org_study_id