Optimized Caloric-proteic Nutrition in Critically Ill Patients

NCT ID: NCT03060668

Last Updated: 2022-03-16

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

Clinical Phase

NA

Total Enrollment

138 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-30

Study Completion Date

2018-12-31

Brief Summary

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In this prospective randomized controlled trial the investigators intend to compare the use of a nutritional therapy based on caloric intake determined by indirect calorimetry and a high protein intake (2.0 to 2.2 g/kg/day) with a nutritional regimen based on 25 Kcal/kg/day and protein intake usually recommended to critically ill patients (1.4 to 1.5 grams/kg/day).

Detailed Description

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OBJECTIVES

To evaluate the effect of nutritional therapy with caloric intake determined by indirect calorimetry and high protein intake (2.0 to 2.2 g/kg/day) compared to nutritional therapy with 25 kcal/kg/day and 1.4 to 1, 5 g/kg/day of protein on short-term outcomes and physical component (PCS) of quality of life after 3 and 6 months of randomization in severe ICU patients.

The primary objective will be the evaluation of the physical component summary (PCS) of SF-36 (Short Form 36), a questionnaire used to evaluate quality of life, validated for the Brazilian population. Patients will be assessed at least 3 and 6 months after randomization.

Secondary objectives: Measurement of handgrip strength measured on the 7th and 14th day of the study and on discharge from the ICU, ICU mortality, hospital mortality, mechanical ventilation time and length of stay in the ICU.

METHODS

The study will include patients over 18 years of age, not pregnant, submitted to mechanical ventilation, whose expectation of stay in the ICU is greater than 3 days.

The sample size was calculated based on the following parameters: patient population under mechanical ventilation, 528, 15% relative risk reduction in the evaluation parameter of the SF-36 tool, Level of significance (α) of 5%, test power of 80%, thus the number of individuals to be sampled will be 294, i.e., two groups of 147 patients. A computer-generated list for randomization and sequentially numbered opaque sealed envelopes is used. The level of significance to reject the null hypothesis will be 5%, that is, a value of p \<0.05 will be considered as statistically significant.

Informed consent was obtained from the patient or a next of kin.

Conditions

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Critically Ill

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Study Group

Caloric needs will be determined by indirect calorimetry. Patients in this group will receive 2.0 to 2.2 grams/kg/day of protein.

Nutritional therapy will be initiated in the first 24 hours after admission.

Nutritional formula will be Peptamen Intense (1.0 kcal/ml, 93 g/L protein (Nestle Health Care).

Group Type EXPERIMENTAL

Peptamen intense

Intervention Type OTHER

Study group will receive a nutritional formula containing 1.0 kcal/ml and 93 g/L of protein

Control Group

Patients in this group will receive 25 Kcal/kg/day and 1.4 to 1.5 grams/kg/day of protein.

Nutritional formula in this group will be Novasource senior (Nestle Health Care).

Nutritional therapy will be initiated in the first 24 hours after admission.

Group Type ACTIVE_COMPARATOR

Novasource senior

Intervention Type OTHER

Control group will receive a nutritional formula containing 1.2 kcal/ml and 65 g/L of protein

Interventions

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Peptamen intense

Study group will receive a nutritional formula containing 1.0 kcal/ml and 93 g/L of protein

Intervention Type OTHER

Novasource senior

Control group will receive a nutritional formula containing 1.2 kcal/ml and 65 g/L of protein

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Critically ill patients Mechanically ventilated Expected length in the ICU \> 3 days

Exclusion Criteria

* Pregnancy Requirement for inspired oxygen (FIO2) \> 0.60 High output bronchopleural fistula
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Sao Domingos

OTHER

Sponsor Role lead

Responsible Party

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José Raimundo Araujo de Azevedo

PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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JOSE R AZEVEDO, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Sao Domingos

Locations

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Hospital Sao Domingos

São Luís, Maranhão, Brazil

Site Status

Countries

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Brazil

Other Identifiers

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HSaoDomingos

Identifier Type: -

Identifier Source: org_study_id

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