Evaluation of Effectiveness of Combining High Protein Intake With Early Physical Exercise During Critical Illness

NCT ID: NCT05877989

Last Updated: 2023-05-26

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

PHASE4

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-01

Study Completion Date

2022-06-30

Brief Summary

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Assessment of Effectiveness of combined high protein intake with early physical exercise by ultrasound measurement of rectus femoris muscle thickness in Intensive Care Unite mechanically ventilated patients.

Detailed Description

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Muscle wasting and weakness is a frequent finding in critically ill patients and is associated with worse short- and long-term outcomes like delayed liberation from mechanical ventilation, longer Intensive Care Unit and hospital stay, worse physical function and quality of life.

Conditions

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Muscle Weakness

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients will receive the amino acid intervention that is provided in addition to 'usual care' enteral and/or parenteral nutrition either enteral or parenteral to target a total protein delivery of 2.0g/kg/day. The physical exercise intervention will be delivered by trained nursing staff,and started as close to the time of randomisation as feasible (ie, within 24hours of randomization). The intervention group will receive exercise sessions, for up to 20 min duration.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard care

Patients will receive usual care in Intensive Care Unit (prescription of a standard nutrition formula (at approximately 20 -25 kcal/ kg/day and protein intake 1.2 g/kg/day) once patients are hemodynamically stable.

Group Type ACTIVE_COMPARATOR

Amino Acid

Intervention Type DRUG

Amino acid enteral and/or parenteral nutrition either enteral or parenteral to target a total protein delivery of 2.0g/kg/day.

Protein and exercise group

patients will receive the amino acid intervention that is provided in addition to 'usual care' enteral and/or parenteral nutrition either enteral or parenteral to target a total protein delivery of 2.0g/kg/day. The physical exercise intervention will be delivered by trained nursing staff, and started as close to the time of randomization as feasible (within 24hours of randomization). The intervention group will receive exercise sessions, for up to 20 min duration (as tolerated by patient). The implementation of physical exercise intervention will be protocolized to provide passive exercise early before weaning and shift to active exercise after weaning and also graduated resistance during each session and between daily sessions.

Group Type ACTIVE_COMPARATOR

Amino Acid

Intervention Type DRUG

Amino acid enteral and/or parenteral nutrition either enteral or parenteral to target a total protein delivery of 2.0g/kg/day.

Physical exercise

Intervention Type PROCEDURE

The physical exercise intervention will be delivered by trained nursing staff, and started as close to the time of randomization as feasible (within 24hours of randomization). The intervention group will receive exercise sessions, for up to 20 min duration (as tolerated by patient).The implementation of physical exercise intervention will be protocolized to provide passive exercise early before weaning and shift to active exercise after weaning and also graduated resistance during each session and between daily sessions.

Interventions

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Amino Acid

Amino acid enteral and/or parenteral nutrition either enteral or parenteral to target a total protein delivery of 2.0g/kg/day.

Intervention Type DRUG

Physical exercise

The physical exercise intervention will be delivered by trained nursing staff, and started as close to the time of randomization as feasible (within 24hours of randomization). The intervention group will receive exercise sessions, for up to 20 min duration (as tolerated by patient).The implementation of physical exercise intervention will be protocolized to provide passive exercise early before weaning and shift to active exercise after weaning and also graduated resistance during each session and between daily sessions.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients in age group 18-60 years
* Expected Intensive Care Unit stay \>4days after enrolment (to permit adequate exposure to the proposed intervention)
* Previously healthy, Well-nourished, subjects (nutric score=0)

Exclusion Criteria

* Renal, liver or heart disease or chronic obstructive pulmonary disease
* Previous immune abnormalities (including treatment with corticosteroids)
* Past history of nutritional problems, chronic use of drugs (as drugs inducing myopathies) or orthopedic problems (such as skeletal fractures or immobilization) in the previous 2 years
* Neuromuscular diseases and patients with amputated lower limbs
* Past or recent history of cancer
* Long term critically ill patients shifted from other hospitals
* Pregnant patients
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tanta University

OTHER

Sponsor Role lead

Responsible Party

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Asmaa Badr Eldin

Doctor Asmaa Badr Eldin

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Tanta University

Tanta, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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34750/6/21

Identifier Type: -

Identifier Source: org_study_id

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