Respiratory Insufficiency Clinical Trial
Official title:
The Efficacy and Safety of Gastric Feeding in Critically Ill Pediatric Patients Receiving Non-invasive Positive Pressure Ventilation: A Pilot Study
The investigators are studying whether it is safe and effective to provide enteral nutrition to critically ill children via the nasogastric route, as opposed to the nasojejunal route, while they are receiving noninvasive positive pressure ventilation.
It has been our experience that the placement of post-pyloric tubes can be difficult, and
that these tubes frequently become obstructed and are difficult to replace, resulting in
lost caloric intake for the patient. The population where this is most relevant is children
receiving Noninvasive Positive Pressure Ventilation (NPPV). NPPV has become increasingly
popular in the Pediatric Intensive Care Unit (PICU) population, due to its perception as a
safe and effective alternative to mechanical ventilation via an endotracheal tube.
Historically, NPPV has been used in children with chronic respiratory insufficiency, but its
application for acute respiratory compromise is increasing. It has been shown to be
effective in disease states associated with hypoventilation, and is now also being applied
to respiratory problems leading to decreased oxygenation. Infants and children receiving
noninvasive ventilation for respiratory failure, which is often infectious in origin, have
significant caloric needs. However, it is our practice not to allow gastric feeding in these
patients due to the fear of gastric distension and vomiting, which carries a risk of
aspiration.
There is no data available on the question of efficacy and safety of gastric feeding in
critically-ill children supported by noninvasive ventilation. Given the ease of
(re)placement, and the potential nutritional benefit of earlier feeding provided by gastric
feeding, it seems clinically important to question the bias against this route of enteral
nutrition in noninvasively ventilated patients. The investigators therefore propose a pilot
randomized trial of gastric versus post-pyloric feeds in patients on NPPV.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
NCT05904652 -
High Flow Nasal Oxygen at Extubation for Adults Requiring a Breathing Tube for Treating Severe Breathing Difficulties
|
N/A | |
| Completed |
NCT04030208 -
Evaluating Safety and Efficacy of Umbulizer in Patients Requiring Intermittent Positive Pressure Ventilation
|
N/A | |
| Recruiting |
NCT03697785 -
Weaning Algorithm for Mechanical VEntilation
|
N/A | |
| Recruiting |
NCT02989051 -
Fluid Restriction Keeps Children Dry
|
Phase 2/Phase 3 | |
| Completed |
NCT02930525 -
Effect of High Flow Nasal Cannula vs. Standard Care on Respiratory Stability in Pediatric Procedural Sedation
|
N/A | |
| Recruiting |
NCT02539732 -
Prediction of Outcome of Weaning From Mechanical Ventilation Using the Electrical Activity of the Diaphragm
|
||
| Enrolling by invitation |
NCT02290236 -
Monitored Saturation Post-ICU
|
N/A | |
| Completed |
NCT02056119 -
RCT of Mesh Versus Jet Nebulizers on Clinical Outcomes During Mechanical Ventilation in the Intensive Care Unit
|
N/A | |
| Terminated |
NCT01583088 -
Early Stage Amyotrophic Lateral Sclerosis Phrenic Stimulation
|
Phase 3 | |
| Withdrawn |
NCT00990119 -
High Flow Therapy (HFT) to Treat Respiratory Insufficiency in Chronic Obstructive Pulmonary Disease (COPD)
|
N/A | |
| Completed |
NCT01411722 -
Electrical Activity of the Diaphragm During the Weaning Period
|
Phase 2 | |
| Completed |
NCT00741949 -
Broncho-alveolar Lavage Under Noninvasive Ventilation With Propofol TCI in Patient With AHRF
|
Phase 3 | |
| Recruiting |
NCT00339053 -
Immunonutrition and Thoracoabdominal Aorta Aneurysm Repair
|
Phase 4 | |
| Recruiting |
NCT00187434 -
Comparison of Two Methods of Continuous Positive Airway Pressure (CPAP) to Support Successful Extubation of Infants of Birth Weights ≤ 1500 Grams (C2CPAP)
|
N/A | |
| Completed |
NCT02687802 -
Respiratory Mechanics and Patient-ventilator Asynchrony Index in Patients With Invasive Mechanical Ventilation
|
||
| Not yet recruiting |
NCT05906030 -
Diaphragm Dysfunction and Ultrasound Perioperatively
|
||
| Not yet recruiting |
NCT05508724 -
Recruitment Manoeuvres in Critically Ill Patients
|
||
| Completed |
NCT03850977 -
Is There an Association Between Chronic Pancreatitis and Pulmonary Function
|
||
| Completed |
NCT02845375 -
Effect of Neuromuscular Blockade and Reversal on Breathing
|
Phase 4 | |
| Recruiting |
NCT03309423 -
Is Venous to Arterial Conversion (v-TAC) of Blood Gas Reliable in Critical Ill Patients in the ICU?
|
N/A |