alle aandoeningen met een Intensive Care indicatie Enteral Nutrition Intensive Care
Conditions
Interventions
Patients will be allocated to either the *cyclic feeding* or *continuous
feeding* group. Patients in the *cyclic feeding* group will receive continuous
enteral feeding in a 12 hour period during day
Sponsors
Leids Universitair Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Age 18 years or older Receiving of or intention to start enteral nutrition via nasogastric or nasoduodenal tube Arterial line Expected duration of ICU admission > 48 hours
Exclusion criteria
Exclusion criteria: • Receiving parenteral nutrition • Oral intake • Prior night-time (20.00h - 8.00h) enteral or parenteral nutrition within the same hospitalization before study inclusion • Readmission to ICU with prior study inclusion • Chronic enteral tube feeding prior to current admission • Presence of one or more contraindications of enteral feeding and/or at significant risk for gastrointestinal tolerance according to standard protocol (including but not limited to gastrointestinal haemorrhage, intestinal ischemia or necrosis, impaired digestive tract integrity due to obstruction or perforation, gastrectomy, enterectomy, history of gastroparesis or oesophageal dysmotility or expected surgery within 24 hours) • Patients with glycaemic emergency (including but not limited to hyperglycaemic hyperosmolar nonketotic coma, diabetic ketoacidosis, severe hypoglycaemia resulting in ICU admission) or patients controlling their glucose levels and insulin dosing via continuous glucose monitoring • Treatment with extracorporeal membrane oxygenation • Severe neurological damage (significant neurological abnormalities such as bleeding, ischemia, neurotrauma or severe encephalopathy with Glasgow Coma Scale
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main study parameters are the 24-h rhythm in core body temperature at day 3 of the study period, assessed by amplitude and acrophase of cosinor fits | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary study parameters are the difference between daytime and night-time melatonin levels at day 3 of the study period, 24-h rhythms in systolic blood pressure, heart rate and heart rate variability, 24-hour rhythms in circulating metabolites, peripheral clock gene expression, depth of sleep, mean daily rate of hyperglycaemia/hypoglycaemia, mean daily glucose variability, mean daily insulin administration, compliance to study protocol, mean daily caloric intake, daily rates of gastric residual volume > 200 mL, 28-day mortality, days on mechanical ventilation and ICU length of stay | — |
Countries
Netherlands
Outcome results
None listed