TICACOS International

NCT ID: NCT01479673

Last Updated: 2013-11-25

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

560 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-11-30

Study Completion Date

2014-12-31

Brief Summary

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The aim of this study is to perform a prospective, randomized, controlled blinded study in critically patients to assess the necessity for measuring daily resting energy expenditure as a guide for nutritional support. Our hypothesis is that tight caloric control will reduce the rate of new infections.

Study Design :Multi-center, randomized, single blinded, controlled study. Study Population: newly-admitted, adult mechanically ventilated ICU patients.

Detailed Description

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Study objectives

To evaluate the effect of tight caloric control in critical patients on:

* The rate of acquired nosocomial infections (Ventilated associated pneumonia, Catheter related infections, Urinary tract infections)
* Mortality rates, length of stay in the ICU and in hospital, length of ventilation and incidence of non-infectious complications.

Primary endpoint:

Rate of nosocomial infections (for definitions see appendage 1) acquired after 48 to 72 hours following admission.

Secondary endpoints

* Metabolic control: glucose concentration, insulin administration, rate of hypoglycemic events.
* Success of tight caloric control: accumulative and maximum negative energy balance.
* Organ function: SOFA score.
* Rate of non-infectious complications: requirement for surgery or occurrence of pressure sores.
* Length of ICU stay and of assisted ventilation (LOS and LOV)
* ICU survival rate.
* Patient status and disposition on day 28 or at hospital discharge.
* 3 \& 6 months survival.

Conditions

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Mechanical Ventilation Complication

Keywords

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Enteral Nutrition Parenteral Nutrition Indirect Calorimetry Intravenous Feeding

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

SINGLE

Participants

Study Groups

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Control group

Patients in this group will receive enteral nutrition/parenteral nutrition or combination of enteral and parenteral nutrition according to the "liberal " regimen, i.e. according to local practice.

Group Type NO_INTERVENTION

No interventions assigned to this group

Indirect Calorimetry

Study group: Indirect Calorimetry (IC) Patients in this group will receive enteral nutrition/parenteral nutrition or combination of enteral and parenteral nutrition according to the individual energy requirements calculated by Indirect Calorimetry measurement of Resting Energy Expenditure (REE).

Group Type EXPERIMENTAL

Indirect Calorimetry measurement of Resting Energy Expenditure .

Intervention Type DIETARY_SUPPLEMENT

Patients in this group will receive enteral nutrition/parenteral nutrition or combination of enteral and parenteral nutrition according to the individual energy requirements calculated by Indirect Calorimetry.

Interventions

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Indirect Calorimetry measurement of Resting Energy Expenditure .

Patients in this group will receive enteral nutrition/parenteral nutrition or combination of enteral and parenteral nutrition according to the individual energy requirements calculated by Indirect Calorimetry.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

1. Mechanically-ventilated adults(Male or Female)admitted to general ICU within the first 48 hours of ICU admission.
2. Age ≥ 18 years;no upper age limit.
3. Expected stay in ICU\> 3 days: \[SAPS II (18) \> ICU median or high-level of nursing care implemented or per clinical impression of attending physician\]
4. Medical and abdomino/thoracic surgery patients, as well as multiple trauma patients with Glasgow Coma Score ≥ 10.

Exclusion Criteria

1. Pregnancy.
2. DNR order.
3. Readmission in the ICU during the same hospitalization/transfer from other ICU.
4. Admission for postoperative monitoring.
5. Respiratory instability: SpO2 \<90% or need for ventilator adjustments during the preceding hour or hyperventilation (Respiratory rate \> 35/min)
6. Bicarbonate infusion, loss of bicarbonate (diarrhea, ureterosogmoidostomy or use of acetazoloamide, ultrafiltration).
7. Aerosolization with nitric oxide or heliox, tracheal insufflations or visible leaks in chest drainage system.
8. FiO2 80% or patients requiring prone position
9. Chronic/acute liver failure:Child-Pugh class C
10. Brain injury for various reasons with Glasgow Coma Scale below 10.
11. Cardiac surgery patients.
12. Patients in the hospital for more than 7 days.
13. Contra indication to use enteral nutrition.
14. Participation in a clinical study with an investigational drug within one month prior to the start of this clinical trial.
15. Ethical issues that will influence subject eligibility.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Baxter Healthcare Corporation

INDUSTRY

Sponsor Role collaborator

Rabin Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Pierre singer

Professor Pierre Singer, MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Pierre Singer, MD, Professor

Role: PRINCIPAL_INVESTIGATOR

RabinMC,Beilinson Hospital

Milana Grinev, RN,Study Coordinator

Role: STUDY_DIRECTOR

RabinMC, Beilinson Hospital ,Petah- Tikva, Israel

Locations

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Rabin Medical Center, Campus Beilinson

Petah Tikva, Petach Tikva, Israel

Site Status RECRUITING

Countries

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Israel

Central Contacts

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Pierre Singer, MD,Professor

Role: CONTACT

Phone: 972-3-9376521

Email: [email protected]

Milana Grinev, RN

Role: CONTACT

Phone: 972-3-9376521

Email: [email protected]

Facility Contacts

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Pierre Singer, Professor,MD

Role: primary

Milana Grinev, Study Coordinator

Role: backup

Other Identifiers

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4329

Identifier Type: -

Identifier Source: org_study_id