Ventilator-Associated Pneumonia
Conditions
Interventions
Intervention Group:The disposable nasogastric tube was placed using the manual blind insertion technique, with the tip advanced distal to the horizontal part of the duodenum for post-pyloric feeding.
Control Group:The disposable nasogastric tube was routinely placed into the stomach for intragastric feeding.
Sponsors
Shenzhen's People Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age >= 18 years; 2. ICU patients anticipated to require invasive mechanical ventilation for>= 48 hours; 3. Indications for gastrointestinal enteral nutrition support; 4. If mechanical ventilation has already been initiated, the duration of ventilation should not exceed 6 hours; 5. The subject (or their legally authorized representative) has provided signed informed consent.
Exclusion criteria
Exclusion criteria: 1. Persistent pneumonia or aspiration observed during direct intubation, with pulmonary infiltration confirmed by chest X-ray upon ICU admission; 2. Pre-existing lung disease that may affect accurate radiological interpretation; 3. Pregnancy; 4. Immunocompromised status: hematological malignancies, solid organ transplantation, congenital or acquired diseases causing significant immunodeficiency, or neutropenia (< 0.5 × 10^9/L); 5. Active gastrointestinal bleeding or acute phase of gastrointestinal perforation; 6. Severe esophageal varices; 7. Corrosive injuries of the esophagus or stomach; 8. Patients with cerebrospinal fluid rhinorrhea or a history of transnasal surgery; 9. Pharyngeal, esophageal stenosis, or obstruction preventing nasogastric tube insertion; 10. Allergy to feeding tube materials (e.g., polyurethane); 11. History of major abdominal surgery (e.g., esophageal, gastric, duodenal, or pancreatic surgery) or other abdominal procedures within the past month; 12. Severe cardiopulmonary dysfunction: severe hypertension, severe arrhythmias, active myocardial infarction, severe heart failure, severe asthma, or respiratory failure preventing supine positioning; 13. Enteral nutrition via jejunostomy or gastrostomy; 14. Anticipated decision for limited treatment (e.g., refusal or withdrawal of treatment) within 7 days; 15. End-of-life status; 16. Participation in other clinical trials within the past 30 days.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of patients with at least one Ventilator-Associated Pneumonia event; | — |
Secondary
| Measure | Time frame |
|---|---|
| Cumulative Incidence of Ventilator-Associated Pneumonia ;Total Number of Ventilator-Associated Pneumonia Events;Spectrum and Proportion of Pathogenic Microorganisms in Ventilator-Associated Pneumonia;Time from Mechanical Ventilation Initiation to Ventilator-Associated Pneumonia Onset;Time to First Occurrence of Ventilator-Associated Pneumonia;Proportion of patients with at least one event of vomiting, enteral feeding intolerance, use of prokinetic agents, or diarrhea;Change in Sequential Organ Failure Assessment (SOFA) Score;Change in Clinical Pulmonary Infection Score (CPIS);Changes in Serum Albumin and C-Reactive Protein Levels During the First Week of Enteral Nutrition;Proportion of Patients with ICU-Acquired Infections (Bloodstream Infections, Catheter-Associated Urinary Tract Infections, and Other Infections);Proportion of Patients Achieving 100% of Target Energy Feeding;Cumulative Caloric Deficit from Day 0 to Day 7;Duration of Mechanical Ventilation;Ventilator-Free Days within 28 Days;Length of ICU Stay;Total Length of Hospital Stay;ICU Mortality Rate;In-Hospital Mortality Rate;28-Day Mortality Rate; | — |
Countries
China
Contacts
Public ContactNan Chuanchuan
Shenzhen's People Hospital
Outcome results
None listed