Insulin Resistance Clinical Trial
Official title:
Randomized Study of Early Nutritional Delivery on Glucose Control, Insulin Resistance and Systemic Inflammation Following Pediatric Cardiac Surgery
NCT number | NCT02274220 |
Other study ID # | 1000046036 |
Secondary ID | |
Status | Completed |
Phase | N/A |
First received | |
Last updated | |
Start date | October 2014 |
Est. completion date | April 2017 |
Verified date | May 2018 |
Source | The Hospital for Sick Children |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The purpose of this randomized trial is to clarify the role of enteral nutrition (EN) on the relationship between cardiopulmonary bypass-induced inflammation and insulin resistance by investigating the effects of two different feeding strategies in infants following cardiac surgery. The study's primary objective is to determine if early and higher volume feeding modifies the relationship between the severity of postoperative systemic inflammation and insulin resistance.
Status | Completed |
Enrollment | 86 |
Est. completion date | April 2017 |
Est. primary completion date | March 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | N/A to 6 Months |
Eligibility |
Inclusion Criteria: - less than 6 months of age - weight > 2.5kg - surgery using cardiopulmonary bypass - expected duration of ventilation > 6 hours Exclusion Criteria: - cardiac transplantation - prematurity (<37 weeks gestation AND under 28 days of life) - intrauterine growth restriction - NEC - structural gastrointestinal anomalies - known preoperative feeding intolerance - diabetes or known metabolic disorder - preoperative liver or renal dysfunction - postoperative contraindication to enteral feeding as determined by clinical team - previous enrollment at an earlier operation - in the opinion of the clinical or research team the patient is too well to participate, such that slow escalation to feeds would lead to hunger and therefore be considered inappropriate. |
Country | Name | City | State |
---|---|---|---|
Canada | The Hospital for Sick Children | Toronto | Ontario |
Lead Sponsor | Collaborator |
---|---|
The Hospital for Sick Children |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Insulin resistance | Plasma insulin concentrations and glucose-insulin ratio (GIR) - GIR will be calculated at each time point and used to reflect insulin resistance, with lower values representing increased resistance | 96 hours | |
Secondary | Postoperative systemic inflammation | Serial measurements of postoperative cytokine (IL-1beta, IL-6, IL-8, IL-10 and TNFalpha) concentrations | 96 hours | |
Secondary | Cardiac output | Postoperative cardiac output measured by respiratory mass spectrometry and Fick equation | 96 hours | |
Secondary | Morbidity score | Postoperative morbidity assessed by a composite morbidity score that includes death, cardiac arrest, use of extracorporeal membrane oxygenation, cardiogenic shock, acute kidney injury, hepatic injury, or hospital-acquired infection. | 96 hours | |
Secondary | Number of subjects achieving goal feeds | 96 hours | ||
Secondary | Number of subjects with NEC/feeding intolerance/protocol violations | 96 hours |
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