None listed
Conditions
Brief summary
In this study of 80 obese (BMI greater than or equal to 30Kg/m2) ICU patients we will estimate requirements and deliver nutrition as per current standard practice in 40 patients; the remaining 40 patients will have their energy requirements measured using indirect calorimetry and the provision of nutrition therapy will be targeted to meet this value. We will measure important outcomes to enable us to determine whether this goal directed approach allows nutrition therapy to better meet the patients requirements, and also whether this difference impacts on the patient’s recovery. We hypothesize that patients who receive Goal Directed Nutrition Therapy will receive a higher proportion of their energy needs (energy delivered divided by measured energy expenditure) and that this may lead to improved clinical and functional outcomes.
Interventions
The intervention is 'Goal Directed Nutrition Therapy' involving the use of indirect calorimetry (IC) to assess energy expenditure, and then targeting the provision of energy from enteral or parenteral nutrition to match this.
To use IC to measure a ventilated patients energy expenditure, the indirect calorimeter is connected to their ventilator circuit to measure the gas exchange and calculate expended energy.
Participants in the intervention group will have IC within 24 hours of enrollment and
The intervention is 'Goal Directed Nutrition Therapy' involving the use of indirect calorimetry (IC) to assess energy expenditure, and then targeting the provision of energy from enteral or parenteral nutrition to match this. To use IC to measure a ventilated patients energy expenditure, the indirect calorimeter is connected to their ventilator circuit to measure the gas exchange and calculate expended energy. Participants in the intervention group will have IC within 24 hours of enrollment and then twice weekly until 14 days or extubation. The test will be carried out by a dietitian. The duration of each test will vary depending on the patient, however the usual duration is 5-20 minutes.
Sponsors
A/Prof Ibolya Nyulasi
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- BMI greater than or equal to 30m2/Kg - Within 72 hours of ICU admission at the time of enrolment - Mechanically ventilated at the time of enrolment and expected to remain ventilated until the day after tomorrow - At least 18 years of age
Exclusion criteria
- There is a long term technical contraindication to a IC measurement - Are not expected to commence nutrition therapy in next 24hrs for any reason - Death is imminent or deemed highly likely in the next 96 hours. - There is a current treatment limitation in place or the patient is unlikely to survive to 6 months due to underlying illness - Are known to be pregnant - The treating clinician does not believe the study to be in the best interest of the patient - Patient is not expected to continue with nutrition therapy for > 72 hours
Outcome results
None listed