Malnutrition
Conditions
Keywords
Enteral Nutrition, Enteral Feeding, nasogastric tubes, gastrostomy tubes, jejunostomy tubes
Brief summary
Surgical patients fed up until the point of surgery will have safe delivery of more calories compared to a group whose feeding is held at midnight prior to surgery.
Detailed description
Nutrition is essential for healing and recovery from illness. Tube feeds are the standard care for patients with prolonged stays in the intensive care unit (ICU) who cannot eat food on their own. Tube feeding means that a tube has been placed in a patient's stomach or small intestine to provide nutrition. When a patient is scheduled for an elective surgery, he/she usually has nothing to eat after midnight prior to the operation. A fasting period before surgery is done to avoid possible side effects during the placement of a breathing tube. Having an empty stomach is thought to decrease the chances of vomiting or aspiration while a breathing tube is placed. (Aspiration occurs when a substance, such as food provided by a tube feed, enters the airway.) However, some patients already have a breathing tube in place. The investigators do not know which is better for patients who already have a breathing tube in place: continuing feedings up until surgery or stopping them the night before. The investigators hypothesize intubated surgical patients randomized to a protocol of feeding up until the point of surgery will have the safe delivery of more calories as compared to a group whose feeding is held at midnight prior to surgery.
Interventions
DIETARY_SUPPLEMENTContinuous Tube Feedings
Tube feeds continued up until elective surgery.
Sponsors
Oregon Health and Science University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
Subjects are randomized to remain NPO at midnight prior to surgery or to continue to receive tube feeding up until surgery time.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Intubated with planned visit to the OR * Admitted to an ICU at OHSU * Receiving enteral nutrition or plan to start enteral nutrition
Exclusion criteria
* Age less than 18 years * Unable to obtain consent from patient or ARR
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total calories delivered | Daily for length of stay (LOS). LOS defined as time from admission to discharge. LOS estimated to average three (3) weeks per participant. | The total number of calories subject consume while receiving tube feeding. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Laboratory values | Daily for length of stay (LOS). LOS defined as time from admission to discharge. LOS estimated to average three (3) weeks per participant. | Laboratory values of interest include: CBC, liver function tests, basic metabolic panel, magnesium, phosphate, alubmin, prealubumin, c-reactive protein, and arterial blood gas. |
| Weight change | Daily for length of stay (LOS). LOS defined as time from admission to discharge. LOS estimated to average three (3) weeks per participant. | The change of weight during hospital admission. |
| number of infections and aspiration events | From date of randomization until the date of documented complication. Subjects will be followed until discharge in case of multiple complications. Date of discharge is estimated to be three (3) weeks post-admission on average. | Number of infections or aspiration events during hospitalization |
Countries
United States
Outcome results
None listed