- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03573453
Comparison of Continuous Versus Intermittent Enteral Nutrition in Critically Ill Patients. (COINN)
March 27, 2023 updated by: Masaryk University
Comparison of Continuous Versus Intermittent Enteral Nutrition in Critically Ill Patients. Effect on Energy and Protein Target Achievement, Tolerance and Incidence of Complications. Monocentric Prospective Randomised Study.
The purpose of the study is to compare continuous versus intermittent strategy for enteral nutrition.
The study will examine if there is a difference in achieving nutritional delivery goals, tolerance and number of complications of enteral nutrition.
Study Overview
Detailed Description
The study will commence following the Approval by The Ethics Research Committee.
All patients admitted to our ICU from the 1st of June 2018 to the 31st of May 2019 will be enrolled after fulfilling the inclusion criteria and in the absence of any exclusion criteria.
Informed consent will be requested.
Enteral nutrition will be administered via nasogastric of orogastric tube.
Patients will be randomised in 2 groups.
In the group of patients receiving continuous feeding will be enteral nutrition administered via enteral feeding pump for at least 16 hours par day.
In the group of patients receiving intermittent feeding will be enteral nutrition administered as 30-60minutes lasting bolus via enteral feeding pump 6 times per day.
Following the administration of the bolus the patient will be placed for 30 minutes in semi-upright sitting position.
Enteral nutrition requirement and composition will be standardised with the adoption of international guidelines.
In 5 subsequent days from the enteral nutrition commencement will be examined if there is a difference in achieving energy and protein targets, tolerance and number of complications of enteral nutrition in between both groups.
As achievement of energy and protein targets will be considered at least 80% of calculated values.
The tolerance of enteral nutrition will be evaluated by the clinical examination of the abdomen, presence of diarrhoea, vomiting and the gastric residual volume of at least 0,5 liter.
As the complications of enteral nutrition will be regarded the aspiration of gastric contents and ventilator associated pneumonia.
Nutritional status parameters will be analysed.
the length of hospital stay, ICU length of stay and 28-day mortality will be also monitored.
Study Type
Interventional
Enrollment (Anticipated)
300
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
-
Brno, Czechia, 62500
- Recruiting
- University Hospital Brno and Masaryk University Brno
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- age between 18 - 80 years
- indication of enteral nutrition with nasogastric or orogastric tube
- Nutrition Risk in the Critically Ill (NUTRIC) score ≥5
- Body mass index between 18 - 50
- mechanical ventilation expected for at least 72 hours
Exclusion Criteria:
- upper gastrointestinal tract surgery in previous medical history
- bowel obstruction
- bowel ischemia
- acute pancreatitis
- severe diarrhoea (>1l/24hours)
- gastrointestinal bleeding
- short bowel syndrome
- malabsorption syndrome in previous medical history
- ongoing enteral nutrition on admission to ICU
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intermittent
enteral nutrition will be administered via enteral feeding pump as 30-60minutes lasting bolus 6 times per day volume of initial bolus will be 80ml.
The volume of bolus will be increased gradually according to tolerance, till the estimated target rate will be reached
|
administration of enteral nutrition
|
Experimental: Continuous
enteral nutrition will be administered via enteral feeding pump for at least 16 hours par day initial rate will be 25ml/hour.
The rate will be increased gradually according to tolerance, till the estimated target rate will be reached
|
administration of enteral nutrition
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Energy target
Time Frame: 5 days from initiation of enteral nutrition
|
Daily assessment of energy intake in critically ill patients with enteral nutrition.Energy target will be achieved if at least 80% of calculated energy intake will be delivered.
|
5 days from initiation of enteral nutrition
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Protein target
Time Frame: 5 days from initiation of enteral nutrition
|
Daily assessment of protein intake in critically ill patients with enteral nutrition.Protein target will be achieved if at least 80% of calculated protein intake will be delivered.
|
5 days from initiation of enteral nutrition
|
Tolerance of enteral nutrition
Time Frame: 5 days from initiation of enteral nutrition
|
Measurement of the gastric residual volume
|
5 days from initiation of enteral nutrition
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Tolerance of enteral nutrition
Time Frame: 5 days from initiation of enteral nutrition
|
Incidence of diarrhoea
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5 days from initiation of enteral nutrition
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Tolerance of enteral nutrition
Time Frame: 5 days from initiation of enteral nutrition
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Incidence of vomiting
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5 days from initiation of enteral nutrition
|
Complications of enteral nutrition
Time Frame: 5 days from initiation of enteral nutrition
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Incidence of aspiration and ventilator associated pneumonia
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5 days from initiation of enteral nutrition
|
Nutritional status
Time Frame: On admission and day 5 from initiation of enteral nutrition
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Blood test : total serum protein test
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On admission and day 5 from initiation of enteral nutrition
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Nutritional status
Time Frame: On admission and day 5 from initiation of enteral nutrition
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Blood test : albumin test
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On admission and day 5 from initiation of enteral nutrition
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Nutritional status
Time Frame: On admission and day 5 from initiation of enteral nutrition
|
Blood test : prealbumin test
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On admission and day 5 from initiation of enteral nutrition
|
Other Outcome Measures
Outcome Measure |
Time Frame |
---|---|
ICU and hospital length of stay
Time Frame: through study completion, an average of 3 weeks
|
through study completion, an average of 3 weeks
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28-day mortality
Time Frame: 28 days from randomisation
|
28 days from randomisation
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
November 25, 2018
Primary Completion (Anticipated)
June 1, 2023
Study Completion (Anticipated)
June 1, 2023
Study Registration Dates
First Submitted
April 17, 2018
First Submitted That Met QC Criteria
June 19, 2018
First Posted (Actual)
June 29, 2018
Study Record Updates
Last Update Posted (Actual)
March 28, 2023
Last Update Submitted That Met QC Criteria
March 27, 2023
Last Verified
March 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CT0012018
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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