None listed
Conditions
Brief summary
Patients admitted to the Intensive care Unit (ICU) are the sickest in hospital, and those that survive experience significant muscle wasting and poor functional outcomes. Nutrition therapy is a fundamental part of clinical care that is thought important to optimise recovery. Historically, invasive mechanical ventilation (IMV) – the insertion of a tube into the trachea to support or replace spontaneous breathing – has been a key strategy in respiratory management; however, for certain causes of respiratory failure there has been increasing use of non-invasive techniques. Current international critical care nutrition guidelines largely focus on those patients that are receiving IMV, and guidance in the setting of non-invasive ventilation (NIV) is lacking. This is partly due to limited high-quality nutritional and functional outcome data in this population group. We propose undertaking a prospective observational study to quantify both nutrition intake and physical and functional outcomes in critically ill patients receiving non-invasive respiratory support.
Interventions
Patients admitted to the Intensive Care Unit who receive non-invasive forms of respiratory support (non-invasive ventilation or high-flow oxygen therapy) as their first form of respiratory therapy will be included in this study. Nutrition intake at days 1, 3-5, and 7 after study inclusion will be observed, and change in physical and functional capacity from days 1 to 7 and at day 90 post admission assessed.
The study involves active participation for patients through the use of a dynamometer for
Patients admitted to the Intensive Care Unit who receive non-invasive forms of respiratory support (non-invasive ventilation or high-flow oxygen therapy) as their first form of respiratory therapy will be included in this study. Nutrition intake at days 1, 3-5, and 7 after study inclusion will be observed, and change in physical and functional capacity from days 1 to 7 and at day 90 post admission assessed. The study involves active participation for patients through the use of a dynamometer for hand grip strength and completion of questionnaires. It is anticipated that patients participation at each time point will take: Day 1: ultrasonography of the Quadricep Muscle Layer Thickness (QMLT), handgrip strength using a dynamometer, 24-hour diet recall, nutrition status assessment using the Patient-generated subjective global assessment, and Barthel Index regarding functional capacity, total ~30-40 minutes Day 3-5: 24-hr diet recall, total ~10-15 minutes Day 7: ultrasonography of the QMLT, handgrip strength using a dynamometer, 24-hour diet recall, nutrition status assessment using the Patient-generated subjective global assessment, total ~30-40 minutes Day 90: 24-hour diet recall, functional capacity using the Barthel Index, quality of life using the Euro-Qol-5D-5L and disability using the WHODAS 2.0, total ~20-30 minutes
Sponsors
Dr Lee-anne Chapple
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
i) First admission to the RAH ICU this hospital episode ii) Are 18 years of age or over iii) Have or are expected to receive non-invasive ventilation or high-flow oxygen therapy while in the ICU
Exclusion criteria
i) Patients expected to be unable to follow commands and give informed consent at any point throughout the study (ie: significant head injury/stroke/neurosurgical intervention) ii) Pregnant iii) Receiving non-invasive respiratory support post extubation from invasive mechanical ventilation iv) Utilising non-invasive respiratory support for the purposes of previously diagnosed Obstructive Sleep Apnoea
Outcome results
None listed