Status:

COMPLETED

Supplemental Parenteral Nutrition in Critically Ill Adults: A Pilot Randomised Controlled Trial

Lead Sponsor:

Australian and New Zealand Intensive Care Research Centre

Collaborating Sponsors:

Baxter Healthcare Corporation

Conditions:

Multiple Organ Failure

Critical Illness

Eligibility:

All Genders

16+ years

Phase:

PHASE2

PHASE3

Brief Summary

One of the essential treatments for assisting patients in their recovery from illness is the provision of nutrition in a liquid form which is delivered into the stomach or as a fluid into the vein. Un...

Detailed Description

The principal objectives are: 1. To determine whether the supplemental Parenteral Nutrition (PN) strategy leads to the delivery of increased amounts of total nutrition (measured as energy delivered),...

Eligibility Criteria

Inclusion

  • Patients in intensive care who meet all of the following:
  • Admitted to intensive care between 48 hours and 72 hours previously
  • Mechanically ventilated at the time of enrollment and expected to remain ventilated until the day after tomorrow
  • At least 16 years of age
  • Have central venous access suitable for PN solution administration
  • Have 1 or more organ system failure (respiratory, cardiovascular or renal) related to their acute illness defined as:
  • Partial pressure of oxygen (PaO2) / Fraction of Inspired oxygen (FiO2) ratio ≤ 300 mmHg
  • Currently on 1 or more continuous vasopressor infusion which were started at least 4 hours ago at a minimum dose of :
  • Dopamine greater than 5 mcg/kg/min
  • Noradrenaline ≥ 0.1mcg/kg/min
  • Adrenaline ≥ 0.1 mcg/kg/min
  • Any dose of total vasopressin
  • Milrinone \>0.25mcg/kg/min)
  • Renal dysfunction defined as
  • In patients without known renal disease:
  • serum creatinine \> 171 mmol/l OR
  • Currently receiving renal replacement therapy
  • In patients with known renal disease:
  • an absolute increase of \> 50% in creatinine from baseline OR
  • Currently receiving renal replacement therapy
  • Currently has an intracranial pressure monitor or ventricular drain in situ
  • Currently receiving extracorporeal membrane oxygenation
  • Currently has a ventricular assist device

Exclusion

  • Both EN and PN cannot be delivered at enrollment (i.e. either an enteral tube or a central venous catheter cannot be placed or clinicians feel that EN or PN cannot be safely administered due to any other reason).
  • Currently receiving PN
  • Standard PN solutions cannot be delivered at enrolment (i.e. clinicians believe that a patient definitely needs a specific parenteral nutrition formulation (e.g. glutamine-supplementation or specific lipid formulation).
  • Death is imminent or deemed highly likely in the next 96 hours.
  • There is a current treatment limitation in place or the patient is unlikely to survive to 6 months due to underlying illness
  • More than 80% of energy requirements have been satisfactorily delivered via the enteral route in the last 24 hours.
  • Are known to be pregnant

Key Trial Info

Start Date :

February 1 2014

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

July 1 2016

Estimated Enrollment :

100 Patients enrolled

Trial Details

Trial ID

NCT01847534

Start Date

February 1 2014

End Date

July 1 2016

Last Update

August 2 2016

Active Locations (6)

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Page 1 of 2 (6 locations)

1

The Alfred Hospital

Melbourne, Victoria, Australia, 3004

2

Geelong Hospital

Geelong, Australia

3

Auckland City Hospital (CVICU)

Auckland, New Zealand

4

Auckland City Hospital (DCCM)

Auckland, New Zealand