The Early Nasojejunal Tube to Meet Energy Requirements in Intensive Care (ENTERIC) Study

Bayside Health

Status: Unknown

Conditions: Critical Illness; Malabsorption Syndromes

Treatments: Procedure: Standard feeding (using nasogastric [NG] tube); Procedure: Early jejunal feeding (using frictional NJ tube)

Study type: Interventional

Funder types: Other

Identifiers

NCT00163813

232/04

Details and patient eligibility

About

This is a multi-centre randomised controlled trial comparing early jejunal feeding (using a frictional nasojejunal [NJ] tube) and standard feeding in critical illness.

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

ICU patients are eligible for enrolment if they meet all of the following:

• Age > 18 years old

• In ICU for < 48 hours prior to enrolment

• Receiving invasive mechanical ventilation (through an endotracheal tube or tracheostomy, but NOT a facemask) with an anticipated need for > 48 hours of mechanical ventilation

• Receiving a continuous infusion of any one of:

  • morphine > 2 mg/hour,
  • fentanyl > 20 mcg/hour, or
  • pethidine > 20 mg/hour

• Either a single GRV > 150 mls (whilst receiving EN via a NG tube) or nasogastric drainage > 500 mls over 12 hours (whether receiving EN or not)

Exclusion criteria

Patients will be ineligible for enrolment if they meet any of the following:

• Previous or recent surgery which has altered the anatomy of the upper gastrointestinal tract (eg. oesophagectomy, gastrectomy, any gastric anastomosis surgery, gastroplasty, pyloroplasty, pancreaticoduodenectomy [Whipple's procedure])
• Known gastric malignancy
• Known oesophageal varices
• Current admission for peptic ulceration
• Current mechanical bowel obstruction
• Current gastrostomy, jejunostomy, or surgically-placed enteral tube in situ
• Contraindication to the use of the nose and mouth for enteral tube insertion (eg. recent facial trauma or surgery)
• Receiving nutritional support prior to ICU admission
• Severe coagulopathy (defined by platelet count < 20 and/or international normalized ratio [INR] > 4.0)

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)