Assessing nutritional status in patients with spinal cord injury

Using doubly labelled water, bioimpedance analysis and dual x-ray absorptiometry in people with spinal cord injury to evaluate energy requirements and body composition

Status

Completed

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12615000178549

Enrollment

Registered

2015-02-24

Start date

2013-12-02

Completion date

2016-06-03

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Nutritional management of patients after spinal cord injury is complex and challenging. Dietitians currently estimate a patient’s nutritional requirements using standard equations of normal resting metabolism, adjusted for activity and stress levels. These equations have never been validated in the spinal cord injured population. To do this, metabolic activity will be measured using a technique called doubly labelled water. Patients are given a single dose of water labelled with a stable isotope. The elimination of the isotope over time directly measures metabolic activity. Weight loss, commonly used to detect malnutrition, cannot distinguish between muscle wasting associated with paralysis and wasting from malnutrition. This study will therefore validate the use of an objective and non-invasive technique called bioelectrical impedance analysis (BIA) to measure segmental body composition (muscle, fat and water) in acute spinal cord injury. With segmental BIA, muscle wasting due to paralysis can be distinguished from wasting due to malnutrition. BIA measures will be validated by dual energy x-ray absorptiometry (DEXA), the gold standard for analysing body composition. BIA can be conducted at bedside and is therefore more clinically feasible and cost-effective for on-going assessment in this population where nutritional needs change through different phases of recovery.

Interventions

Participants with recent spinal cord injury will be given a single dose of doubly labelled water (99% deuterium and 10% 18O) based on body weight (1.35gm per kg). Urine samples will be collected pre-dose and at regular intervals over a two week period post dose. Participants will also undergo bioimpedance analysis and dual x-ray absorptiometry.

Eligibility

Sex/Gender

All

Age

18 Years to 70 Years

Healthy volunteers

Inclusion criteria

Traumatic spinal cord injury less than 6 weeks previously Surgical fixation of fracture

Exclusion criteria

Ventilator dependent Medically unstable

Outcome results