None listed
Conditions
Interventions
Others(Clinical Nutrition Strategy) : Participants will be randomly assigned in a 1:1 ratio to either the enteral nutrition (EN) group or the parenteral nutrition (PN) group. Both groups will have ide
Serum lactate level < 2 mmol/L
Clinical determination that enteral nutrition is feasible.
Sponsors
Samsung Medical Center
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1) Screening Criteria Participants must meet all of the following conditions: Adults aged 19 years or older Patients admitted to the intensive care unit (ICU) Patients receiving vasopressor therapy for shock A history of maximum vasopressor requirement with a vasopressor-inotropic score (VIS) = 12, defined as: VIS = dopamine dose (µg/kg/min) + dobutamine dose (µg/kg/min) + 10 × milrinone dose (µg/kg/min) + 100 × epinephrine dose (µg/kg/min) + 100 × norepinephrine dose (µg/kg/min) + 10,000 × vasopressin dose (U/kg/min) 2) Inclusion Criteria Participants must meet all of the following: Fulfillment of all screening criteria Availability of central venous access suitable for parenteral nutrition (PN) Decreasing vasopressor requirement, defined as a current VIS = 12
Exclusion criteria
Exclusion criteria: Exclusion Criteria Participants meeting any of the following will be excluded: Presence of contraindications to enteral nutrition (EN) or parenteral nutrition (PN) at the time of enrollment Conditions requiring specific nutritional management, including but not limited to long-term home EN or PN, or a diagnosis of refeeding syndrome Pregnancy or breastfeeding Severe comorbid conditions with an estimated life expectancy of less than 3 months Documented do-not-resuscitate (DNR) order Active gastrointestinal bleeding Gastrointestinal surgery within the past 1 month Current participation in another randomized controlled trial comparing EN and PN
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| ICU mortality and ICU acquired infections | — |
Secondary
| Measure | Time frame |
|---|---|
| mortality;in-hospital mortality;mortality;ICU length of stay;Hospital length of stay;Time to wean from vasopressor support;Feeding intolerance;Gastrointestinal complications (vomiting, diarrhea, bowel ischemia, pseud-obstruction, other gastrointestinal complications);Time to reach nutritional target;Daily calorie/protein supplement;Clinical Frailty score ;Body mass index at enrollment;lactate clearance;New renal replacement therapy during ICU stay;New insulin therapy during ICU stay;Prokinetic drug use, daily during ICU stay;SOFA score from day 0 to day 7 | — |
Countries
Korea, Republic of
Contacts
Public ContactJeong Hoon yang
Samsung Medical Center
Outcome results
None listed