Does a Ketogenic Diet Causes Ketosis in Patients on Intensive Care?

NCT ID: NCT02763553

Last Updated: 2016-11-09

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

PHASE2

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-31

Study Completion Date

2017-03-31

Brief Summary

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The purpose of this study is to assess if an enteral ketogenic feed will cause a ketotic state in critically ill patients on intensive care.

Detailed Description

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This pilot study is a prospective, single-centre, unblinded, parallel-group, randomised controlled, Phase IIb trial comparing standard enteral nutrition with an enteral ketogenic feed. The trial has a simple, pragmatic design and will be analysed on an intention-to-treat basis. It aims to recruit 10 patients from a single University teaching hospital adult general ICU. The anticipated recruitment period is 4 weeks.

Adult patients admitted to intensive care and expected to require enteral feed via a nasogastric tube for at least 5 days and who fulfil other eligibility criteria will be allocated at random to receive either standard feed (Nutrison Protein Plus Multi Fibre) or a ketogenic enteral feed (Nutrison KetoCal 4:1).

The primary endpoint will be increase in ketone body concentration in serum. Secondary endpoints will include, time taken to achieve a ketotic state, ketone levels in critical care patients who are not absorbing enteral feed, glucose levels in patients on a ketone feed, triglyceride and cholesterol levels, creatinine kinase levels and development of a metabolic acidosis.

Adult ICU patients will be eligible to be included in this study if they are expected to require enteral feed via a nasogastric or nasojejunal tube or established percutaneous jejunostomy for at least 5 days. Practically, this will be achieved by screening ventilated patients as they will require enteral feeding Major exclusion criteria include contraindications to ketogenic feeds, contraindications to enteral feeding, a new (\< 5 days) percutaneous jejunostomy.

The intervention will continue until 14 days if the patient still requires enteral nutrition or until able to commence a normal diet orally.

Conditions

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Ketosis

Keywords

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Ketone Bodies Enteral Nutrition Ketogenic Diet

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard Feed

Standard enteral feed (Nutrison ProteinPlus MF 1.28) containing 11.1g of carbohydrate and 3.8g of fat per 100kcal. Given as a continuous feed via a naso-gastric tube as per standard feeding protocol.

Group Type ACTIVE_COMPARATOR

Standard Feed

Intervention Type DIETARY_SUPPLEMENT

Standard enteral feed used in critical care patients requiring nutrition via a nasogastric tube

Ketogenic Feed

A low-carbohydrate, high-fat enteral feed (Nutrison KetoCal 4:1) containing 0.4g of carbohydrate and 10g of fat per 100kcal. Given as a continuous feed via a naso-gastric tube as per standard feeding protocol.

Group Type EXPERIMENTAL

Ketogenic Feed

Intervention Type DIETARY_SUPPLEMENT

A low-carbohydrate, high-fat feed designed to induce a ketotic state.

Interventions

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Ketogenic Feed

A low-carbohydrate, high-fat feed designed to induce a ketotic state.

Intervention Type DIETARY_SUPPLEMENT

Standard Feed

Standard enteral feed used in critical care patients requiring nutrition via a nasogastric tube

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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Nutrison KetoCal 4:1 Nutrison ProteinPlus MultiFibre 1.28

Eligibility Criteria

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Inclusion Criteria

* Adults who require mechanical ventilation within 72 hours of admission to intensive care

Exclusion Criteria

* Known intolerance to the ketogenic diet
* Contraindication to standard protocolised enteral feeding
* Pregnancy
* Severe liver disease (known decompensated liver cirrhosis, previous liver transplant, acute hepatitis (bilirubin \>100, ALT \>500)
* Severe metabolic acidosis (pH \< 7.2, HCO3 \< 15mmol/L) that has not been corrected prior to enrolment in the study
* Patients predicted to stay less than 24 hours on intensive care
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospitals Bristol and Weston NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kieron D Rooney, MBBS

Role: STUDY_CHAIR

University Hospitals Bristol and Weston NHS Foundation Trust

Central Contacts

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Kieron D Rooney, MBBS

Role: CONTACT

Phone: +44 117 342 7137

Email: [email protected]

Other Identifiers

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AN/2015/5042

Identifier Type: -

Identifier Source: org_study_id