Micronutrients in Children in Critical Care With Cardiac Conditions
NCT ID: NCT02409706
Last Updated: 2016-06-16
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
COMPLETED
Total Enrollment
50 participants
Study Classification
OBSERVATIONAL
Study Start Date
2014-08-31
Study Completion Date
2016-06-30
Brief Summary
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This study aims to explore the frequency and types of micronutrient deficiencies in a sample of UK children with CHD using standard and novel markers in blood. The study will also explore whether micronutrient deficiencies increase the risk of complications after heart surgery. This study will identify any nutrient deficiencies that need monitoring in clinical practice.
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Detailed Description
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Congenital heart disease (CHD) is one of the most common birth defects in the UK. Children with CHD are at risk of underfeeding and undernutrition. This is due to both the increased nutritional requirements of the disease and sometimes clinical management, which often hinders delivery of optimal nutrition.There are as yet no studies assessing micronutrient body stores in children with CHD or whether micronutrient deficiencies predict poor clinical outcomes, such as post-operative complications, after major cardiac operations.
This study aims to explore the frequency, types and associations of micronutrient deficiencies in children with CHD using standard and novel markers in blood. The study will also explore whether micronutrient deficiencies increase the risk of complications after heart surgery. This study will identify any nutrient deficiencies that need monitoring in clinical practice.
This study aims to explore the frequency, types and associations of micronutrient deficiencies in children with CHD using standard and novel markers in blood. The study will also explore whether micronutrient deficiencies increase the risk of complications after heart surgery. This study will identify any nutrient deficiencies that need monitoring in clinical practice.
Conditions
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Heart Defects, Congenital
Study Design
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Observational Model Type
COHORT
Study Time Perspective
PROSPECTIVE
Eligibility Criteria
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Inclusion Criteria
* Infant or child admitted for elective congenital cardiac surgery at the Royal Hospital for Sick Children, Glasgow.
* Aged less than 5 years old
* Aged less than 5 years old
Exclusion Criteria
* Infant or child admitted for emergency cardiac surgery
* Infant or child whose carer with parental responsibility is unable to communicate in English
* Infant or child whose carer with parental responsibility is unable to communicate in English
Maximum Eligible Age
5 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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University of Glasgow
OTHER
Sponsor Role
collaborator
NHS Greater Glasgow and Clyde
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Neil Spenceley, MBChB
Role: PRINCIPAL_INVESTIGATOR
Royal Hospital for Sick Children, Glasgow
Locations
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Royal Hospital for Sick Children
Glasgow, Glasgow City, United Kingdom
Site Status
Countries
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United Kingdom
References
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Dolk H, Loane M, Garne E. The prevalence of congenital anomalies in Europe. Adv Exp Med Biol. 2010;686:349-64. doi: 10.1007/978-90-481-9485-8_20.
Reference Type
BACKGROUND
van der Bom T, Zomer AC, Zwinderman AH, Meijboom FJ, Bouma BJ, Mulder BJ. The changing epidemiology of congenital heart disease. Nat Rev Cardiol. 2011 Jan;8(1):50-60. doi: 10.1038/nrcardio.2010.166. Epub 2010 Nov 2.
Reference Type
BACKGROUND
Nydegger A, Walsh A, Penny DJ, Henning R, Bines JE. Changes in resting energy expenditure in children with congenital heart disease. Eur J Clin Nutr. 2009 Mar;63(3):392-7. doi: 10.1038/sj.ejcn.1602956. Epub 2007 Nov 14.
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BACKGROUND
Mitchell IM, Logan RW, Pollock JC, Jamieson MP. Nutritional status of children with congenital heart disease. Br Heart J. 1995 Mar;73(3):277-83. doi: 10.1136/hrt.73.3.277.
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BACKGROUND
Kogon BE, Ramaswamy V, Todd K, Plattner C, Kirshbom PM, Kanter KR, Simsic J. Feeding difficulty in newborns following congenital heart surgery. Congenit Heart Dis. 2007 Sep-Oct;2(5):332-7. doi: 10.1111/j.1747-0803.2007.00121.x.
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BACKGROUND
Hulst JM, Joosten KF, Tibboel D, van Goudoever JB. Causes and consequences of inadequate substrate supply to pediatric ICU patients. Curr Opin Clin Nutr Metab Care. 2006 May;9(3):297-303. doi: 10.1097/01.mco.0000222115.91783.71.
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BACKGROUND
Bird J, Gentles E, Diamantidi K, Spenceley N, Gerasimidis K. Nutritional intake in a cardiac PICU improved following the introduction of enteral nutrition guidelines. Journal of American Dietetic Association 2013
Reference Type
BACKGROUND
Bird J, Gentles E, Diamantidi K, Alfheeaid H, MacLeod I, Ellis D, Spenceley N, Davidson M, Gerasimidis K. Micronutrient intake in a mixed speciality paediatric intensive care unit. World Congress of Paediatric Intensive Care 2011
Reference Type
BACKGROUND
Gentles E, Bird J, Davidson M, Spenceley N, Ellis D and Macleod I. The impact of fasting, fluid restriction and slow initiation and advancement of enteral feeds on daily energy intake in PICU. Paediatric Intenstive Care Society Annual Conference 2010
Reference Type
BACKGROUND
Briassoulis G, Zavras N, Hatzis T. Malnutrition, nutritional indices, and early enteral feeding in critically ill children. Nutrition. 2001 Jul-Aug;17(7-8):548-57. doi: 10.1016/s0899-9007(01)00578-0.
Reference Type
BACKGROUND
Vaidyanathan B, Radhakrishnan R, Sarala DA, Sundaram KR, Kumar RK. What determines nutritional recovery in malnourished children after correction of congenital heart defects? Pediatrics. 2009 Aug;124(2):e294-9. doi: 10.1542/peds.2009-0141. Epub 2009 Jul 5.
Reference Type
BACKGROUND
Padley JR, Cole AD, Pye VE, Chard RB, Nicholson IA, Jacobe S, Baines D, Badawi N, Walker K, Scarfe G, Leclair K, Sholler GF, Winlaw DS. Five-year analysis of operative mortality and neonatal outcomes in congenital heart disease. Heart Lung Circ. 2011 Jul;20(7):460-7. doi: 10.1016/j.hlc.2011.03.009. Epub 2011 Apr 21.
Reference Type
BACKGROUND
Thiagarajan RR, Laussen PC. Mortality as an outcome measure following cardiac surgery for congenital heart disease in the current era. Paediatr Anaesth. 2011 May;21(5):604-8. doi: 10.1111/j.1460-9592.2011.03580.x.
Reference Type
BACKGROUND
Cander B, Dundar ZD, Gul M, Girisgin S. Prognostic value of serum zinc levels in critically ill patients. J Crit Care. 2011 Feb;26(1):42-6. doi: 10.1016/j.jcrc.2010.06.002. Epub 2010 Jul 23.
Reference Type
BACKGROUND
Stoppe C, Schalte G, Rossaint R, Coburn M, Graf B, Spillner J, Marx G, Rex S. The intraoperative decrease of selenium is associated with the postoperative development of multiorgan dysfunction in cardiac surgical patients. Crit Care Med. 2011 Aug;39(8):1879-85. doi: 10.1097/CCM.0b013e3182190d48.
Reference Type
BACKGROUND
Manzanares W, Biestro A, Torre MH, Galusso F, Facchin G, Hardy G. High-dose selenium reduces ventilator-associated pneumonia and illness severity in critically ill patients with systemic inflammation. Intensive Care Med. 2011 Jul;37(7):1120-7. doi: 10.1007/s00134-011-2212-6. Epub 2011 Mar 29.
Reference Type
BACKGROUND
Gray A, McMillan DC, Wilson C, Williamson C, O'Reilly DS, Talwar D. The relationship between plasma and red cell concentrations of vitamins thiamine diphosphate, flavin adenine dinucleotide and pyridoxal 5-phosphate following elective knee arthroplasty. Clin Nutr. 2004 Oct;23(5):1080-3. doi: 10.1016/j.clnu.2004.01.013.
Reference Type
BACKGROUND
Gray A, McMillan DC, Wilson C, Williamson C, O'Reilly DS, Talwar D. The relationship between the acute changes in the systemic inflammatory response, lipid soluble antioxidant vitamins and lipid peroxidation following elective knee arthroplasty. Clin Nutr. 2005 Oct;24(5):746-50. doi: 10.1016/j.clnu.2005.02.008. Epub 2005 Apr 8.
Reference Type
BACKGROUND
Quasim T, McMillan DC, Talwar D, Vasilaki A, St J O'Reilly D, Kinsella J. The relationship between plasma and red cell B-vitamin concentrations in critically-ill patients. Clin Nutr. 2005 Dec;24(6):956-60. doi: 10.1016/j.clnu.2005.06.004. Epub 2005 Jul 28.
Reference Type
BACKGROUND
Vasilaki AT, McMillan DC, Kinsella J, Duncan A, O'Reilly DS, Talwar D. Relation between pyridoxal and pyridoxal phosphate concentrations in plasma, red cells, and white cells in patients with critical illness. Am J Clin Nutr. 2008 Jul;88(1):140-6. doi: 10.1093/ajcn/88.1.140.
Reference Type
BACKGROUND
Vasilaki AT, Leivaditi D, Talwar D, Kinsella J, Duncan A, O'Reilly DS, McMillan DC. Assessment of vitamin E status in patients with systemic inflammatory response syndrome: plasma, plasma corrected for lipids or red blood cell measurements? Clin Chim Acta. 2009 Nov;409(1-2):41-5. doi: 10.1016/j.cca.2009.08.008. Epub 2009 Aug 19.
Reference Type
BACKGROUND
Vasilaki AT, McMillan DC, Kinsella J, Duncan A, O'Reilly DS, Talwar D. Relation between riboflavin, flavin mononucleotide and flavin adenine dinucleotide concentrations in plasma and red cells in patients with critical illness. Clin Chim Acta. 2010 Nov 11;411(21-22):1750-5. doi: 10.1016/j.cca.2010.07.024. Epub 2010 Jul 24.
Reference Type
BACKGROUND
Reid D, Toole BJ, Knox S, Talwar D, Harten J, O'Reilly DS, Blackwell S, Kinsella J, McMillan DC, Wallace AM. The relation between acute changes in the systemic inflammatory response and plasma 25-hydroxyvitamin D concentrations after elective knee arthroplasty. Am J Clin Nutr. 2011 May;93(5):1006-11. doi: 10.3945/ajcn.110.008490. Epub 2011 Mar 16.
Reference Type
BACKGROUND
Talwar D, Quasim T, McMillan DC, Kinsella J, Williamson C, O'Reilly DS. Pyridoxal phosphate decreases in plasma but not erythrocytes during systemic inflammatory response. Clin Chem. 2003 Mar;49(3):515-8. doi: 10.1373/49.3.515. No abstract available.
Reference Type
BACKGROUND
Gerasimidis K, Talwar D, Duncan A, Moyes P, Buchanan E, Hassan K, O'Reilly D, McGrogan P, Edwards CA. Impact of exclusive enteral nutrition on body composition and circulating micronutrients in plasma and erythrocytes of children with active Crohn's disease. Inflamm Bowel Dis. 2012 Sep;18(9):1672-81. doi: 10.1002/ibd.21916. Epub 2011 Nov 8.
Reference Type
BACKGROUND
Duncan A, Dean P, Simm M, O'Reilly DS, Kinsella J. Zinc supplementation in intensive care: results of a UK survey. J Crit Care. 2012 Feb;27(1):102.e1-6. doi: 10.1016/j.jcrc.2011.07.083. Epub 2011 Sep 29.
Reference Type
BACKGROUND
Gerasimidis K, Edwards C, Stefanowicz F, Galloway P, McGrogan P, Duncan A, Talwar D. Micronutrient status in children with IBD: true deficiencies or epiphenomenon of the systemic inflammatory response. J Pediatr Gastroenterol Nutr. 2013 Jun;56(6):e50-1. doi: 10.1097/MPG.0b013e31828f1e86. No abstract available.
Reference Type
BACKGROUND
Oakes EJ, Lyon TD, Duncan A, Gray A, Talwar D, O'Reilly DS. Acute inflammatory response does not affect erythrocyte concentrations of copper, zinc and selenium. Clin Nutr. 2008 Feb;27(1):115-20. doi: 10.1016/j.clnu.2007.10.003. Epub 2007 Nov 26.
Reference Type
BACKGROUND
Duncan A, Talwar D, McMillan DC, Stefanowicz F, O'Reilly DS. Quantitative data on the magnitude of the systemic inflammatory response and its effect on micronutrient status based on plasma measurements. Am J Clin Nutr. 2012 Jan;95(1):64-71. doi: 10.3945/ajcn.111.023812. Epub 2011 Dec 7.
Reference Type
BACKGROUND
Gerasimidis K, Keane O, Macleod I, Flynn DM, Wright CM. A four-stage evaluation of the Paediatric Yorkhill Malnutrition Score in a tertiary paediatric hospital and a district general hospital. Br J Nutr. 2010 Sep;104(5):751-6. doi: 10.1017/S0007114510001121. Epub 2010 Apr 19.
Reference Type
BACKGROUND
Gerasimidis K, Macleod I, Finlayson L, McGuckin C, Wright C, Flynn D, McGrogan P, Maclean A, Love E, Swinbank I, Mohammed T, McAuley M. Introduction of Paediatric Yorkhill Malnutrition Score--challenges and impact on nursing practice. J Clin Nurs. 2012 Dec;21(23-24):3583-6. doi: 10.1111/j.1365-2702.2012.04164.x. No abstract available.
Reference Type
BACKGROUND
Stefanowicz FA, Talwar D, O'Reilly DS, Dickinson N, Atkinson J, Hursthouse AS, Rankin J, Duncan A. Erythrocyte selenium concentration as a marker of selenium status. Clin Nutr. 2013 Oct;32(5):837-42. doi: 10.1016/j.clnu.2013.01.005. Epub 2013 Jan 16.
Reference Type
BACKGROUND
Other Identifiers
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GN14KH356
Identifier Type: OTHER
Identifier Source: secondary_id
GN14KH356
Identifier Type: -
Identifier Source: org_study_id
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