Dysphagia, Dysphagia, Swallowing Function, Diet Modification, Dysphagia Diet, Diet Standardization
Conditions
Keywords
DYSPHAGIA, ICU, POST- EXTUBATION
Brief summary
The aim of this study is to evaluate the effects of using the GUSS-ICU Safe Nutrition Program after extubation in Intensive Care Unit patients. This randomized controlled trial will be conducted in the Anesthesia Intensive Care Unit of Bakırköy Dr. Sadi Konuk Training and Research Hospital. Eligible participants will be randomly assigned to either the control group (usual care/routine follow-up group) or the intervention group (GUSS-ICU patients). Patients undergoing GUSS-ICU assessment will continue the nutritional program, as directed by the scale, for four days. Data are recorded on the first and last day. The data will then be evaluated in conjunction with the control group data.
Detailed description
The aim of this study is to evaluate the effects of using the GUSS-ICU Safe Nutrition Program after extubation in intensive care patients. This randomized controlled trial will be conducted in the Anesthesia Intensive Care Unit of Bakırköy Dr. Sadi Konuk Training and Research Hospital. Patients who meet the criteria will be randomized into either an intervention group or a control group. Patients in the control group will receive routine post-extubation care, follow-up, and a nutrition plan. On day 1, baseline data will be collected using the m-NUTRIC score, APACHE-II, SOFA, Charlson Comorbidity Index (CCI), Scored Patient-Generated Subjective Global Assessment (PG-SGA), and a patient data form. Routine follow-up and nutrition plans will be continued. At the end of day 4, the m-NUTRIC score, APACHE-II, SOFA, Charlson Comorbidity Index (CCI), Scored Patient-Generated Subjective Global Assessment (PG-SGA), and a patient data form will be completed. Patients in the intervention group undergo a GUSS-ICU assessment within the first 4 hours after extubation. Nutrition planning is based on the assessment scores. On day 1, baseline data includes the m-NUTRIC score, APACHE-II, SOFA, Charlson Comorbidity Index (CCI), Scored Patient-Generated Subjective Global Assessment (PG-SGA), and a patient data form. Nutritional monitoring and follow-up are continued for 4 days. At the end of day 4, the m-NUTRIC score, APACHE-II, SOFA, Charlson Comorbidity Index (CCI), Scored Patient-Generated Subjective Global Assessment (PG-SGA), and a patient data form are completed. The data will then be evaluated in conjunction with the control group data.
Interventions
OTHERNutrion plan based on GUSS-ICU scale
To ensure a rapid and accurate transition to post-extubation nutrition, patients will be assessed using the GUSS-ICU scale at 4 hours after extubation. A nutrition plan will be created based on the patient's GUSS-ICU score and will be maintained for 4 days.
Sponsors
Istanbul University - Cerrahpasa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Age 18 and over Patients expected to remain intubated for more than 24 hours. Patients who have been extubated for no more than 4 hours.
Exclusion criteria
* Patients with neuromuscular disease * Patients requiring non-invasive ventilation for more than 6 hours after extubation * Patients being followed in the terminal phase * Patients with a tracheostomy cannula * Patients with a history of dysphagia * Patients with head/neck cancer or surgery * Patients with existing facial fractures * Patients with a RASS score not within the 0-2 range * Patients at high risk of bleeding (INR ≥ 2.0, Platelet count ≤ 50,000).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in the frequency of GI symptoms in intensive care patients who received a post-extubation GUSS-ICU safe nutrition program | On the 1st and 4th days after extubation | Changes in the frequency of GI symptoms in intensive care patients who received a GUSS-ICU Safe Nutrition Program after extubation will be evaluated with PG-SGA and Patient Data Form. |
| Change in the incidence of aspiration pneumonia in intensive care patients receiving a GUSS-ICU safe nutrition program after extubation | On the 1st and 4th days after extubation | The data in the patient follow-up form will be evaluated with the clinician's supervision. |
| Changes in malnutrition risk scores and findings in intensive care patients who received a GUSS-ICU Safe Nutrition Program after extubation | On the 1st and 4th days after extubation | Changes in malnutrition risk scores and findings in intensive care patients who received the GUSS-ICU Safe Nutrition Program after extubation will be evaluated with the PG-SGA. |
| Changes in dehydration findings in intensive care patients who received a GUSS-ICU Safe Nutrition Program after extubation | On the 1st and 4th days after extubation | Dehydration findings in intensive care patients who are applied GUSS-ICU Safe Nutrition Program after extubation will be evaluated with PG-SGA and patient data form. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Scored Patient-Generated Subjective Global Assessment (PG-SGA) score | On the 1st and 4th days after extubation | Possible effects on nutrition will be evaluated using the Scored Patient-Generated Subjective Global Assessment (PG-SGA). |
| Change in Modified Nutrition Risk in the Critically Ill (m-NUTRIC) score | On the 1st and 4th days after extubation | It will be assessed with the Modified Nutrition Risk in the Critically Ill (m-NUTRIC) score. |
| Change in APACHE II score | On the 1st and 4th days after extubation | The effects on mortality will be evaluated with the APACHE II score. |
| Change in SOFA (Sequential Organ Failure Assessment) Score | On the 1st and 4th days after extubation | SOFA (Sequential Organ Failure Assessment) Score will be evaluated to determine the effects on mortality. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in the number of days from tube feeding to oral feeding | From the first to the last day of follow-up after extubation | Change in the number of days from tube feeding to oral feeding |
| Change in oral intake (calorie) | From the first to the last day of follow-up after extubation | Change in oral intake (calorie) |
Countries
Turkey (Türkiye)
Contacts
Primary ContactMerve TURKAY
Backup ContactZeliha TÜLEK
Outcome results
None listed