Critically Ill
Conditions
Keywords
critically ill, intensive care, enteral nutrition
Brief summary
The goal of this study is to evaluate whether a standard enteral nutrition protocol can improve the efficiency in achieving nutritional goals and improve prognosis in critically ill patients.
Detailed description
As investigators all know, the nutrition status in critically ill patients is associated with the prognosis of these patients. And it has been confirmed that early enteral nutrition results in better outcome. However,some epidemiological investigation reported that in most intensive care unit, the phenomenon of delayed feeding or under feeding are not uncommon. In 2007, a study reported that the percentage of early enteral nutrition within 48h is 64%, based on mechanical ventilated patients in 208 intensive care unit nationally. Other study indicated that the calorie supported by the enteral nutrition only constitute 50% of the target calorie. Several studies have showed that the application of a standard enteral nutrition protocol could result in an improvement in the delivery of enteral feedings to patients. However, there is no such study in China.The goal of this study is to evaluate whether a standard enteral nutrition protocol can improve the efficiency in achieving nutritional goals and improve prognosis in critically ill patients.
Interventions
OTHERA standard enteral nutrition protocol
Patients in the experimental arm, the practice of enteral nutrition will based on a standard protocol. The core content of this protocol includes five step：1. Whether the participants need nutrition therapy? 2. The choice of nutrition way? 3. Nasogastric tube or nasointestinal tube? 4. The choice of enteral nutrition type? 5. The target calorie and protein of the participants? And how to achieve these target？(In this study, the practice of the above protocol is the only intervention).
Sponsors
Department of Emergency Medicine, People's Hospital of Shaoxing, Shaoxing, China.
Department of Emergency Medicine, Wenzhou Central Hospital, Wenzhou, China.
Department of Emergency Medicine, The First People's Hospital of Hangzhou, Hangzhou, China.
Department of Emergency Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Sir Run Run Shaw Hospital
Emergency Department, The First People's Hospital of Huzhou, Huzhou, China.
Department of Critical Care Medicine, The First People's Hospital of Xiaoshan District, Hangzhou, China.
Emergency Department, Jinhua Hospital of Zhejiang University, Jinhua, China.
Department of Critical Care Medicine, The First People's Hospital of Fuyang district, Hangzhou, China.
Department of Critical Care Medicine, Beilun District People's Hospital, Ningbo, China.
The Affiliated Hospital of Hangzhou Normal University
The Third Affiliated Hospital of Wenzhou Medical University
Yuyao People's Hospital
Department of Emergency Intensive Care Unit, The Second Hospital of Jiaxing, No 1518, Huanchengbei Rd, Jiaxing, China.
Second Affiliated Hospital, School of Medicine, Zhejiang University
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Before-after study model
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Critically ill patients who is expected the length of ICU stay for more than 3 days
Exclusion criteria
* Patients who can obtain enough calorie through independent oral feeding. Patients aged less than 18 years. Patients who are pregnant or breastfeeding. Patients who are burned. Patients with malignant tumor terminal stages of diseases
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The proportion of patients receiving enteral nutrition in patients receiving any type of nutrition | 7 days after ICU admission |
| The time from hospital admission to the begain Enteral nutrition. | 7 days after ICU admission |
| The time from hospital admission to achieve the target calorie. | 7 days after ICU admission |
| The proportion of patients receiving parenteral nutrition in patients receiving any type of nutrition | 7 days after ICU admission |
| The proportion of patients receiving Enteral plus supplement parenteral in patients receiving any type of nutrition | 7 days after ICU admission |
Secondary
| Measure | Time frame |
|---|---|
| ICU mortality. | From date of the ICU admission until discharge form ICU,assessed up to 12 months |
| The incidence of complications(Diarrhea , abdominal distension, nausea and vomiting.) | From date of the ICU admission until discharge form ICU,assessed up to 12 months |
| Hospital mortality. | From date of the ICU admission until discharge form hospital,assessed up to 12 months |
| ICU length of stay | From date of the ICU admission until discharge form ICU,assessed up to 12 months |
| Duration of mechanical ventilation. | From date of the initiation of mechanical ventilation until weaning,assessed up to 12 months |
| ICU fee. | From date of the ICU admission until discharge form ICU,assessed up to 12 months |
Countries
China
Outcome results
None listed