Critical Care Clinical Trial
— ENINCOOfficial title:
"Efficacy of Intermittent Enteral Nutrition Versus Continuous Administration in Intensive Care Patients for the Reduction of Complications. Randomized Clinical Trial"
The goal of this clinical trial is to Determine efficacy of intermittent enteral nutrition vs continuous enteral nutrition in adults patients with a nasogastric tube in a intensive care unit. The main question[s] it aims to answer are: - Reduction of gastrointestinal and respiratory complications - Evaluate the achievement of the caloric objective Informed consent will be requested from participants who meet the inclusion criteria. The participants will be randomized into two groups: control group (continuous enteral nutrition) or experimental group (intermittent enteral nutrition) Researchers will compare intermittent enteral nutrition vs continuous to see if there is a reduction in gastrointestinal and respiratory complications.
Status | Recruiting |
Enrollment | 190 |
Est. completion date | April 30, 2024 |
Est. primary completion date | February 29, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Patients admitted to ICU of University General Hospital of Albacete - Need for enteral nutrition by nasogastric tube in the first 48 hours - Signed informed consent Exclusion Criteria: - Insulin dependent diabetic patients - Abdominal surgery - Dire prognosis |
Country | Name | City | State |
---|---|---|---|
Spain | Maria Dolores Saiz Vinuesa | Albacete |
Lead Sponsor | Collaborator |
---|---|
Complejo Hospitalario Universitario de Albacete | University of Castilla-La Mancha |
Spain,
Chen YC. Critical analysis of the factors associated with enteral feeding in preventing VAP: a systematic review. J Chin Med Assoc. 2009 Apr;72(4):171-8. doi: 10.1016/S1726-4901(09)70049-8. — View Citation
Heffernan AJ, Talekar C, Henain M, Purcell L, Palmer M, White H. Comparison of continuous versus intermittent enteral feeding in critically ill patients: a systematic review and meta-analysis. Crit Care. 2022 Oct 25;26(1):325. doi: 10.1186/s13054-022-0414 — View Citation
Ichimaru S. Methods of Enteral Nutrition Administration in Critically Ill Patients: Continuous, Cyclic, Intermittent, and Bolus Feeding. Nutr Clin Pract. 2018 Dec;33(6):790-795. doi: 10.1002/ncp.10105. Epub 2018 Jun 20. — View Citation
Lewis SR, Schofield-Robinson OJ, Alderson P, Smith AF. Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit. Cochrane Database Syst Rev. 2018 Jun 8;6(6):CD012276. do — View Citation
Patel JJ, Rosenthal MD, Heyland DK. Intermittent versus continuous feeding in critically ill adults. Curr Opin Clin Nutr Metab Care. 2018 Mar;21(2):116-120. doi: 10.1097/MCO.0000000000000447. — View Citation
Serpa LF, Kimura M, Faintuch J, Ceconello I. Effects of continuous versus bolus infusion of enteral nutrition in critical patients. Rev Hosp Clin Fac Med Sao Paulo. 2003 Jan-Feb;58(1):9-14. doi: 10.1590/s0041-87812003000100003. Epub 2003 Apr 30. — View Citation
Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, Hiesmayr M, Mayer K, Montejo JC, Pichard C, Preiser JC, van Zanten ARH, Oczkowski S, Szczeklik W, Bischoff SC. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. — View Citation
Tavares de Araujo VM, Gomes PC, Caporossi C. Enteral nutrition in critical patients; should the administration be continuous or intermittent? Nutr Hosp. 2014 Mar 1;29(3):563-7. doi: 10.3305/nh.2014.29.3.7169. — View Citation
Thong D, Halim Z, Chia J, Chua F, Wong A. Systematic review and meta-analysis of the effectiveness of continuous vs intermittent enteral nutrition in critically ill adults. JPEN J Parenter Enteral Nutr. 2022 Aug;46(6):1243-1257. doi: 10.1002/jpen.2324. Ep — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Respiratory Complications | Respiratory aspiration of gastric content | during ICU stay (maximum 15 days) | |
Primary | Gastrointestinal Complications | Digestive intolerance: Diarrhea, vomiting, increased gastric residual volume(GRV) | during ICU stay (maximum 15 days) | |
Secondary | Achievement of the caloric objective | Time in hours to reach caloric goal | during ICU stay (up to 15 days) | |
Secondary | Nutritional status: MNA | Measure with:Mini Nutritional Assessment,(MNA) 12-14 points: Normal nutritional status 8-11 points: risk of malnutrition 0-7 points: Malnutrition | up to two days after admission to the ICU | |
Secondary | Changes in blood glucose | Episodes of hypoglycemia or hyperglycemia | during ICU stay (maximum 15 days) | |
Secondary | ICU Stay | Days of stay in ICU | From date of randomization until 100 months | |
Secondary | Mortality | Percentage of deaths in ICU | until the date of death from any cause until 100 months | |
Secondary | Change of type of EN administration | Change of EN administration modality | during ICU stay (maximum 15 days) | |
Secondary | Nutritional status:Glim Criteria | Measure with: Glim criteria: Phenotypic criteria:Non-volitional weight loss (%) Low BMI (kg/m2)Reduced muscle mass(calf circumference (cm)) Etiologic criteria: Reduced food intake or assimilation. Inflammation
*Requires at least one phenotypic criterion and one etiologic criterion for the diagnosis of malnutrition |
up to two days after admission to the ICU | |
Secondary | Nutritional status: Biochemical values | Measure with:biochemical values: albumin, prealbumin, total protein | up to two days after admission to the ICU |
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