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Impact of Early Enteral vs. Parenteral Nutrition on Risk of Gastric-Content Aspiration in Patients Requiring Mechanical Ventilation and Catecholamines

C

Centre Hospitalier Departemental Vendee

Status

Terminated

Conditions

Shock
Acute Respiratory Failure

Treatments

Other: Enteral nutrition
Other: Parenteral nutrition

Study type

Interventional

Funder types

Other

Identifiers

NCT03411447
CHD085-13

Details and patient eligibility

About

To evaluate the impact of enteral nutrition on microaspiration of gastric content and pharyngeal secretions

Full description

A common obstacle to enteral nutrition is gastrointestinal intolerance, with regurgitations potentially responsible for gastric-content aspiration. Several studies involving technetium 99m (99mTc) labeling of gastric contents have established that gastric-fluid microaspiration is common in critically ill patients receiving both endotracheal ventilation and enteral nutrition. However, to our knowledge, no studies have specifically addressed the role for enteral nutrition in the occurrence of microaspiration. The objective of this ancillary study is to compare the frequency of gastric-content microaspiration in patients given enteral versus parenteral nutrition during the NUTRIREA2 trial. The new knowledge of risk factors for microaspiration provided by this study may help to improve strategies for preventing microaspiration and ventilator-associated pneumonia (VAP).

Enrollment

139 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Invasive mechanical ventilation expected to be required more than 48 hours
  • Nutrition started within 24 hours after initiation of endotracheal mechanical ventilation
  • Treatment with vasoactive drug administered via a central venous catheter
  • Age over 18 years
  • Signed information

Exclusion criteria

  • Abdominal surgery within 1 month before inclusion
  • History of esophageal, gastric, duodenal or pancreatic surgery
  • Bleeding from the esophagus, stomach or bowel

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

139 participants in 2 patient groups

Parenteral nutrition
Active Comparator group
Description:
Patients will receive parenteral nutrition during the first week of mechanical ventilation. After Day 3, the parenteral route may be switched to the enteral route if shock resolve (vasoactive drug stopped since 24 hours and serum lactate level \< 2 mmol/l). After Day 7, all patients will be fed via the enteral route.
Treatment:
Other: Parenteral nutrition
Enteral nutrition
Active Comparator group
Description:
Patients will receive nutrition only via the enteral route during the firs week of invasive mechanical ventilation.
Treatment:
Other: Enteral nutrition

Trial contacts and locations

6

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Data sourced from clinicaltrials.gov

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