Assessment of Nutrient Absorption in Enterally Fed Post-intensive Care Unit Patients Using Bomb Calorimetry: do the Calories Stick

NCT ID: NCT06923813

Last Updated: 2025-12-18

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

RECRUITING

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-01

Study Completion Date

2026-04-01

Brief Summary

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This study focuses on understanding how well patients who have recovered from an ICU stay absorb nutrients when receiving enteral (tube) feeding. Proper nutrition is crucial for recovery, but we don't fully understand how efficiently enteral feeding works in ICU survivors. The study will use advanced techniques like bomb calorimetry to measure the energy content of stool, and indirect calorimetry to measure patients' resting energy expenditure (REE). This will help assess the effectiveness of enteral feeding in these patients, providing valuable information about their metabolic needs and nutritional status.

The study will also look into the environmental impact of enteral feeding, particularly food waste. By understanding how much of the nutrition is absorbed versus excreted, the study hopes to suggest more sustainable feeding practices and reduce unnecessary waste in hospitals.

Key Goals:

* Primary Goal: Measure how much energy from enteral feeding is absorbed by patients post-ICU by analyzing their stool and energy expenditure.
* Secondary Goal: Assess how enteral feeding can be made more sustainable, with less waste generated from unused nutritional products.

This research will help improve nutritional care for ICU patients, enhance recovery, and potentially lead to more environmentally friendly healthcare practices.

Detailed Description

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This study investigates the absorption efficiency of enteral nutrition in patients recovering from an intensive care unit (ICU) stay. Nutritional support is critical in the recovery of ICU patients, and enteral feeding is commonly used due to its benefits in preserving gut integrity and reducing infection risks. However, there is limited data on the actual absorption of nutrients in these patients, particularly in terms of how much of the provided energy is utilized versus excreted.

The primary focus of this study is to quantify the caloric intake and the caloric content of excreted stool to determine the efficiency of nutrient absorption in post-ICU patients. This will be done using bomb calorimetry, which measures the energy content in stool samples, and indirect calorimetry to assess the patients' resting energy expenditure (REE).

The study design is prospective, interventional, and single-center, involving 20 post-ICU patients who meet the inclusion criteria. Detailed tracking of caloric intake, including both enteral feeding and supplemental infusion calories, will be performed daily. Stool samples will be collected for three days, with the nonabsorbable blue dye marker method used to track the specific stool produced during this period. These stool samples will be freeze-dried, formed into pellets, and analyzed using the Parr 6200 Isoperibol Calorimeter to measure their energy content.

The secondary objective is to evaluate the sustainability of enteral feeding practices by assessing the amount of waste generated, such as unused nutritional formulas and tubing. This includes quantifying food waste in the hospital, focusing on nutrition that is not consumed, absorbed, or excreted.

By understanding the actual energy absorption in ICU survivors, this study aims to provide insights that will optimize nutritional strategies, improve patient recovery, and contribute to cost-effective, environmentally sustainable healthcare practices.

Conditions

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Post-ICU Patients Fully Enterally Fed

Keywords

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PEG tube indirect calorimetry nasogastric

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

20 post-ICU patients who are fully enterally fed (PEG- or nasogastric tube)
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Participants

20 post-ICU patients who are fully enterally fed (PEG- or nasogastric tube). Step-by-Step Process: Every time a patient is included, all steps (caloric intake measurement, stool sample collection, blending, freezing, and freeze drying) will be performed sequentially. Bomb Calorimetry can be conducted either systematicallyfor a few patients at a time or all at once after all samples have been collected.

Group Type EXPERIMENTAL

caloric intake measurement

Intervention Type OTHER

Detailed daily tracking of the enteral feeding provided to each patient, inclusing the type and amount of nutritional formula administered. Apart from the enteral intake, supplemental calories provided by infusion (e.g. glucose) will be recorded to ensure accurate measurement of caloric intake.

stool sample collection

Intervention Type PROCEDURE

* a nonabsorbable blue dye marker will be administered at the start and end of the stool collection period to precisely indentify the stool produced within a specific time frame.
* stool will be collected for three days. Each sample will be collected, weighted and labeled with the date and time, then stored at -20°C.
* only stool samples from the appearance of the first dye marker to the appearance of the second dye marker will be saved and analyzed.
* bomb calorimetry preparation

* blending and dilution: each stool sample will be put into a blender and mixed with an equal amount of water
* freeze dying: the diluted stool will be placed into freeze-dye flasks and frozen at -20°C. The next day, the flasks will be placed into a freeze dryer for 48hours.
* pellet formation: the freeze-dried samples will be formed into 1-gram pellets and stored until calorimetry
* calorimetry analysis: the Parr 6200 isoperibol calorimeter will be used to measure the energy content of the stool pellets

energy expenditure measurement

Intervention Type OTHER

performing indirect calorimetry to measure the REE of each patient

Interventions

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caloric intake measurement

Detailed daily tracking of the enteral feeding provided to each patient, inclusing the type and amount of nutritional formula administered. Apart from the enteral intake, supplemental calories provided by infusion (e.g. glucose) will be recorded to ensure accurate measurement of caloric intake.

Intervention Type OTHER

stool sample collection

* a nonabsorbable blue dye marker will be administered at the start and end of the stool collection period to precisely indentify the stool produced within a specific time frame.
* stool will be collected for three days. Each sample will be collected, weighted and labeled with the date and time, then stored at -20°C.
* only stool samples from the appearance of the first dye marker to the appearance of the second dye marker will be saved and analyzed.
* bomb calorimetry preparation

* blending and dilution: each stool sample will be put into a blender and mixed with an equal amount of water
* freeze dying: the diluted stool will be placed into freeze-dye flasks and frozen at -20°C. The next day, the flasks will be placed into a freeze dryer for 48hours.
* pellet formation: the freeze-dried samples will be formed into 1-gram pellets and stored until calorimetry
* calorimetry analysis: the Parr 6200 isoperibol calorimeter will be used to measure the energy content of the stool pellets

Intervention Type PROCEDURE

energy expenditure measurement

performing indirect calorimetry to measure the REE of each patient

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* age of 18 years or older
* minimum ICU stay of 7 days
* fully dependent on enteral feeding (nasogastric or PEG-tube)
* ability of the patient or representative to understand and sign written informed consent in Dutch, French or English

Exclusion Criteria

* known inflammatory bowel disease
* known malabsorptive gastrointestinal disease
* history of small bowel resection
* concomitant use of serotoninergic or sympathomimetic medications (oa. setrone, tryptans, antidepressants, methylphenidate, monoamine oxidase inhibitors, tramadol)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Société des Produits Nestlé (SPN)

INDUSTRY

Sponsor Role collaborator

Universitair Ziekenhuis Brussel

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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UZ Brussel

Brussels, , Belgium

Site Status NOT_YET_RECRUITING

UZ Brussel

Jette, , Belgium

Site Status RECRUITING

Countries

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Belgium

Central Contacts

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Elisabeth De Waele

Role: CONTACT

Phone: 02476 3354

Email: [email protected]

Facility Contacts

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UZ Brussel

Role: primary

Maridi Aerts

Role: primary

Other Identifiers

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STICKY

Identifier Type: -

Identifier Source: org_study_id