RecruitingNot ApplicableNCT04475666

Replacing Protein Via Enteral Nutrition in Critically Ill Patients

Replacing Protein Via Enteral Nutrition in a Stepwise Approach in Critically Ill Patients: An International, Multicenter Randomized Controlled Trial


Sponsor

King Abdullah International Medical Research Center

Enrollment

2,502 participants

Start Date

Sep 21, 2020

Study Type

INTERVENTIONAL

Conditions

Summary

The investigator will investigate the effect of supplemental enteral protein (1.2 g/kg/day) added to standard formula to achieve high amount of enteral protein (range 2-2.4 g/kg/day) given from ICU day 5 until ICU discharge up to ICU day 90 as compared to no supplemental enteral protein to achieve moderate amount enteral protein (0.8-1.2 g/kg/day), given in conjunction with similar amounts of stepwise caloric administration in the two groups on all-cause 90-day mortality.


Eligibility

Min Age: 18 Years

Inclusion Criteria3

  • Age ≥18-years old
  • Patient started on enteral nutrition (EN) via nasogastric/orogastric or duodenal or percutaneous endoscopic gastrostomy (PEG) or jejunostomy tubes.
  • The patient is on invasive mechanical ventilation and unlikely to be discharged from ICU next day.

Exclusion Criteria10

  • Lack of commitment to full life support or brain death. Patients with "Do Not Resuscitate" order but with commitment to ongoing life support can be enrolled.
  • Patients on any amount of parenteral nutrition (PN) in ICU at the time of screening, whether PN is used alone or in combination with enteral nutrition. Non-nutritional calories (dextrose, propofol, citrate) not considered as PN.
  • Patients who received an average protein of more than 0.8g/kg/day in the first 4 ICU days.
  • Patients being fed entirely through oral route - i.e. those who are eating.
  • Pregnancy.
  • Burn patients.
  • Prisoners or those undergoing forced treatment.
  • Patients with hepatic encephalopathy or Child C liver cirrhosis
  • Inherited defect of amino acid metabolism.
  • Allergies to protein supplement

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Interventions

OTHERReplenish protein group

For patients with Body mass index(BMI) \<30, use pre-ICU actual body weight(BW) for the calculation; if unavailable, use weight on ICU admission. For patients with BMI \>=30, use adjusted body weight

OTHERStandard protein group

For patients with BMI \<30, use pre-ICU actual BW for the calculation; if unavailable, use weight on ICU admission. For patients with BMI \>=30, use adjusted body weight


Locations(2)

King Abdulaziz Medical city

Jeddah, Jeddah, Saudi Arabia

Intensive Care Unit, King Abdulaziz Medical City

Riyadh, Saudi Arabia

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NCT04475666


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