None listed
Conditions
Brief summary
Critically ill patients suffer from catabolism, i.e. protein loss, which may contribute to complications such as muscle weakness, protracted ventilator treatment, and delayed recovery. Appropriate feeding may alleviate catabolism, but ideal feeding strategies are controversial, partly because the underlying physiology is poorly understood. An earlier study (Berg A et al. (2013), Crit Care 17(4): R158) has shown that protein catabolism is reduced when a higher dose of nutrition is given by the intravenous route. We now investigate the effect of a full dose vs. lower dose nutrition regimen where feeding is given via a nasogastric feeding tube, gastrostomy or jejunostomy. Using stable isotope techniques, we measure whether whole-body protein turnover is affected by the dose of nutrition.
Interventions
Critically ill patients from a medical/surgical adult ICU who are on stable, normocaloric, enteral nutrition via nasogastric tube/gastrostomy/jejunostomy are studied twice on consecutive days. Indirect calorimetry is performed to determine energy expenditure. Enteral nutrition is given at 100% of energy expenditure (normocaloric) for 24 hrs on one day, and at 50% of energy expenditure (hypocaloric) for 24 hrs on the other, in randomised order.
Measurements of whole-body protein kinetics are ma
Critically ill patients from a medical/surgical adult ICU who are on stable, normocaloric, enteral nutrition via nasogastric tube/gastrostomy/jejunostomy are studied twice on consecutive days. Indirect calorimetry is performed to determine energy expenditure. Enteral nutrition is given at 100% of energy expenditure (normocaloric) for 24 hrs on one day, and at 50% of energy expenditure (hypocaloric) for 24 hrs on the other, in randomised order. Measurements of whole-body protein kinetics are made during the last 2 hrs of each 24 hr study period. Intravenous infusions of stable isotope labeled phenylalanine and tyrosine are administered to measure whole-body protein turnover. A different stable isotope labeled phenylalanine tracer is administered enterally during the last 5 hrs of each 24 hr study period to enable calculation of dietary contribution to whole-body protein turnover. Parameters of steady-state whole body protein turnover are calculated from arterial plasma enrichments of isotope labeled phenylalanine and tyrosine tracers.
Sponsors
Prof Olav Rooyackers
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Critically ill patients on stable, normocaloric, enteral nutrition nutrition via nasogastric feeding tube/gastrostomy/jejunostomy
Exclusion criteria
Blood transfusion during study period, intolerance of enteral nutrition at time of recruitment
Outcome results
None listed