Feeding Tube Practices and Colonization of the Preterm Stomach in the First Week of Life
Feeding Tube Practices and Colonization of the Preterm Stomach in the First Week of Life: A Randomized Controlled Trial
Project summary
Rationale
Many NICU's replace their feeding tubes once a week or more rarely in order to avoid disturbing the infants. The researchers discovered that there are high concentrations of potentially pathogenic bacteria in the yield of resident nasogastric feeding tubes, even within one day of use (own data, manuscript submitted). Preterm infants are vulnerable to the colonization of the gut, and development of dysbiosis might lead to necrotizing enterocolitis. The researchers speculate if replacing the resident feeding tube every day and thereby decreasing the amount of potentially pathogenic bacteria given to the infants via the feeding tube will lead to fewer bacteria present in the upper part of the gastrointestinal tract of the infant and hence a reduced competition with probiotic colonization.
Objectives
The investigators plan to conduct an intervention study in premature infants receiving probiotics (< 32 weeks of gestation) where the feeding tube will be replaced every day in the intervention group and once a week (standard practice) in the control group. The main outcome will be bacterial concentration in the stomach after one week of life.
Methods
The study is a prospective, randomized controlled trial in preterm infants. Infants will be randomized to the intervention group in which the tube is replaced every day or the control group which will follow normal practice in the department. The intervention will last one week. The infants will be followed until discharge. The investigators plan to include 11 infants in each group.
Primary outcome
Concentration of bacteria in gastric aspirates on day seven.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Copenhagen, Denmark, 2100
- Department of Neonatology, Rigshospitalet
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Under 32 weeks GA at birth
- Admission time considered to be more than seven days
- Signed informed consent within 48 hours after birth
Exclusion Criteria:
- Transfer to another hospital within seven days
- Major gastrointestinal malformations
- No tube feeding within first 48 h of birth
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention
Feeding tube daily replacement
|
Feeding tubes replaced once a day in the first week of life.
|
|
No Intervention: Control
Feeding tubes replaced as normal practice in the department (normally once a week).
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Concentration (CFU/ml) of bacteria in gastric aspirates
Time Frame: on day seven of life
|
on day seven of life
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of patients with potentially pathogenic bacteria at any concentration in gastric aspirates
Time Frame: day seven of life.
|
Qualitative differences between bacteria found in the gastric aspirates of intervention and control group.
Potentially pathogenic bacteria= Enterobacteriaceae and S. aureus.
|
day seven of life.
|
|
pH (acidity) of gastric aspirates
Time Frame: First week of life
|
First week of life
|
|
|
Number of patients with probiotics cultured from gastric aspirates aspirates
Time Frame: First week of life
|
Determination of whether probiotic bacteria are detectable in the gastric aspirates, and in which concentration.
|
First week of life
|
|
Concentration (CFU/ml) of bacteria in maternal milk
Time Frame: First week of life
|
Investigate any correlation between maternal milk flora and gastric flora.
|
First week of life
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Gorm Greisen, Professor, Rigshospitalet, Denmark
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- H-15021673
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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