The Effect of Prucalopride on Gastric Emptying in Intensive Care Unit Patients

NCT ID: NCT05496179

Last Updated: 2024-04-12

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

PHASE1/PHASE2

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-30

Study Completion Date

2023-07-15

Brief Summary

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to compare the effectiveness as well as the safety of prucalopride against metoclopramide as the first line treatment for feeding intolerance in critically ill patients.

Detailed Description

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Provision of nutrition support to the critically ill is now established as an essential part of patient care where aiming toward 100% of the predicted target may have resulted in reduced mortality and increased ventilator-free days in those who are premorbidly malnourished. Despite these reported benefits, clinicians continue to deliver little more than half of the enteral nutrition (EN) they plan to provide, due to gastric motility disorders, patient intolerance and clinical interruptions. Also despite the availability of numerous clinical practice guidelines (CPGs) focused on feeding critically ill patients, observational studies have consistently demonstrated persistent and significant gaps between guideline recommendations and actual nutrition practice. Consequently, underfeeding is prevalent in the intensive care unit (ICU), with patients on average receiving only 60 % of the calories that are prescribed. Moreover, Among the barriers to adequate nutritional supply in the ICU which contributes to nutritional status deterioration, gastrointestinal disorders causing enteral feed intolerance are the most important and the most often mentioned in the literature. when gastric emptying was measured in critically ill patients, 46 % of them had evidence of delayed gastric emptying. Untreated slow gastric emptying has a plethora of clinical consequences such as vomiting, aspiration of gastric contents, pneumonia, and contributes significantly to the frequent interruptions and cessation of EN in the ICU, which results in inadequate nutritional delivery. Studies have shown an association between feeding intolerance, prolonged intensive care unit (ICU) stay, and increased risk of death.

Conditions

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Enteral Feeding Intolerance

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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Prucalopride

Patients will receive prucalopride (2 mg) once daily for 7 days.

Group Type ACTIVE_COMPARATOR

Prucalopride

Intervention Type DRUG

Prokinetic

Metoclopramide

Patients will receive metoclopramide (10 mg) three times daily for 7 days.

Group Type ACTIVE_COMPARATOR

Metoclopramide

Intervention Type DRUG

Prokinetic

Interventions

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Prucalopride

Prokinetic

Intervention Type DRUG

Metoclopramide

Prokinetic

Intervention Type DRUG

Other Intervention Names

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Resolor Primperan

Eligibility Criteria

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Inclusion Criteria

* Patients aging between 18 and 60 years (of both sexes) who are admitted to the ICU and are expected to stay in the ICU for not less than 7 days and are prescribed enteral feeding through naso- or oro-gastric tube whose modified nutritional risk in the critically ill (mNUTRIC) score is of more than or equal

Exclusion Criteria

* Patients who met the following criteria were excluded:

* Age less than 18 years or more than 60 years.
* Previous upper gastrointestinal tract surgery, obstruction, hemorrhage or history of GI disease.
* Clinically significant hepatic dysfunction. (\>3 times above the upper end of normal range of bilirubin, γ-glutamyl transferase, aspartate transaminase, or lactate dehydrogenase)
* Regular use of H2 blockers, prokinetic, proton pump inhibitor or anticholinergic agents for previous 4 weeks.
* Patients with arrhythmia or atrioventricular blocks.
* Any condition or comorbid disease that might interfere with gastric emptying such as diabetes.
* Patients with head injuries.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Future University in Egypt

OTHER

Sponsor Role collaborator

Ain Shams University

OTHER

Sponsor Role lead

Responsible Party

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Eman Mohamed El Mokadem

Lecturer of Clinical Pharmacy

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Eman Elmokadem, PhD

Role: PRINCIPAL_INVESTIGATOR

Future University in Egypt

Locations

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Kasr Al Ainy Hospital

Cairo, , Egypt

Site Status

Countries

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Egypt

References

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Elmokadem EM, Abou El Fadl DK, Eissa N, Alnassar NA, Bassiouny AM, Hanna Samy AE, El Said NO. Comparison of enteral prucalopride versus intravenous metoclopramide for feeding intolerance in patients with critical illness: a randomized double-blinded study. Front Pharmacol. 2024 Nov 8;15:1413246. doi: 10.3389/fphar.2024.1413246. eCollection 2024.

Reference Type DERIVED
PMID: 39584139 (View on PubMed)

Other Identifiers

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Future University in Egypt

Identifier Type: -

Identifier Source: org_study_id

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