Acute Gastrointestinal Injury, Critical Illness
Conditions
Brief summary
In critical ill patients, feeding protocol is one of the important factor which determines the successful implementation of enteral nutrition（EN）. Acute gastrointestinal injury(AGI) affects feeding tolerance, which greatly determines the successful implementation of feeding protocol. In our previously study, we found that transabdominal intestinal sonography is helpful to diagnosis AGI. Thus in this study ,we apply transabdominal gastrointestinal sonography to feeding protocol, to assess the feasibility of gastrointestinal sonography assisted enteral nutrition and its impact on critical ill patients.
Detailed description
Patients meeting inclusion and exclusion criteria were randomly assigned to the intervention group and control group. During the first week of initiation of nutrition, enteral nutrition was conducted according to different procedures to observe the impact of different feeding procedures on clinical indicators
Interventions
OTHERImplement nutrition therapy according a procedure assisted by gastrointestinal ultrasound
Once the critical ill patients is stable, enteral nutrition was initiated following a procedure assisted by gastrointestinal ultrasound.
Sponsors
Chinese Medical Association
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* The age is not less than 18 years * within 24 hours after entering ICU * Acute Physiology and Chronic Health Evaluation II (APACHE II) score \> 8 * the estimated length of stay in ICU is more than 3 days * informed consent
Exclusion criteria
* The normal anatomy of stomach, small intestine or the right colon was significantly changed (Gastrectomy, esophagectomy, pancreaticoduodenectomy, gastrointestinal bypass surgery, the presence of short bowel syndrome,etc.) * Uncontrolled gastrointestinal bleeding * Uncontrolled intestinal obstruction * Uncontrolled mesenteric vascular disease * Pregnancy * breastfeeding * Received enteral nutrition or parenteral nutrition within 24 hours prior to ICU admission * Predict death within 48 hours after ICU admission * Enrolled in this study before.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Target-reaching rate through enteral route | Within first week | percentage of participants who reach target calorie through enteral route |
Secondary
| Measure | Time frame |
|---|---|
| Serum creatinine | Day0,1,3,5,7 |
| Platelet count | Day0,1,3,5,7 |
| The incidence of feeding intolerance | Within first week |
| The application of parenteral nutrition | Within first week |
| The application of prokinetic drugs | Within first week |
| The ues of vasoactive drugs | Within first week |
| Mechanical ventilation | Within first week |
| Continuous renal replacement | Within first week |
| The CRP level | Day0/1/3/5/7 |
| Mortality | Day28、Day60、during hospitalization |
| ICU length of stay | During ICU stay |
| Total bilirubin | Day0,1,3,5,7 |
| Length of hospital stay | During hospital stay |
Countries
China
Contacts
PRINCIPAL_INVESTIGATORWenKui Yu, Professor
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Outcome results
None listed