- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04464057
Safety and Effectiveness of Early Feeding After Bowel Anastomosis in Neonates or Infants
December 10, 2022 updated by: Weibing Tang
The study is primary designed to evaluate the safety and effectiveness of early feeding after bowel anastomosis, and observe the effect of early postoperative feeding on promoting postoperative rehabilitation and reducing parenteral nutrition
Study Overview
Status
Completed
Intervention / Treatment
Detailed Description
Intestinal anastomosis is a common operation for the treatment of digestive tract diseases of newborns and infants.
It is not be defined that when should begin oral feeding after intestinal anastomosis.
Poor anastomotic healing or anastomotic leakage is the most serious complication after intestinal anastomosis, which often leads to severe abdominal infection, peritonitis and even death.
Nowadays, it is believed that the causes of poor anastomotic healing or anastomotic leakage are various, including contaminated during the operation, the blood supplyment of the bowel edges at both ends of the anastomosis, anemia, anastomosis technique, type of surgery (selective or emergency), and anastomotic tension .
The traditional view is that early feeding may increase the anastomotic tension, which may lead to poor anastomotic healing or leakage, so a lot of surgeons often take a fasting for 4-5 days after intestinal anastomosis to ensure good anastomotic healing, however there is no enough evidence for this view.
On the contrary, the current research confirms that after intestinal anastomosis, under fasting conditions, the digestive system still has 1-2 liters of fluid through the anastomosis, so even if it is given postoperative oral feeding, It would not excessively increase the digestive fluid through the anastomosis.
Obviously, the early guess that the anastomotic tension is increased is lacking in theoretical evidence.
In recent years, with the in-depth study of intestinal function, intestinal mucosal barrier function and intestinal flora, early enteral nutrition has stretched more and more attention, which is believed could stimulate intestinal digestive fluid secretion, promote intestinal mucosal metabolism and repair, avoid intestinal villi atrophy, reduce intestinal bacterial translocation, promote intestinal function recovery and intestinal peristalsis.
Postoperative intestinal obstruction is also an important reason for hindering early enteral nutrition, but current research believes that postoperative intestinal obstruction is often temporary, and in most cases will be relieved 4-8 hours after surgery.
European Society of Parenteral Enteral Nutrition (ESPEN ) recommended that enteral nutrition should be performed within 24 hours after intestinal anastomosis, but it needs to be fully evaluated according to the children's own tolerance and the type of surgery.
A large number of studies and meta-analysis have confirmed that early enteral nutrition is safe and feasible after intestinal anastomosis in adults, but there are still few studies in children, especially whether early enteral surgery can be performed after intestinal anastomosis is currently rarely reported in neonates and infants.
This study evaluated the feasibility and effectiveness of early oral enteral nutrition in neonates and infants after intestinal anastomosis through a prospective study.
Study Type
Interventional
Enrollment (Actual)
947
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
-
-
Anhui
-
Hefei, Anhui, China
- Anhui Provincial Children's Hispital
-
-
Jiangsu
-
Xuzhou, Jiangsu, China, 210000
- Xuzhou CHildren's Hospital Affilated to Xuzhou Medical College
-
-
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
1 year to 4 months (Child)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- (1)neonates or infants less than 12 months (2)Intestinal anastomosis, including small intestine and colon anastomosis
Exclusion Criteria:
- (1) Premature infants or children with a weight of less than 2.5 kg during surgery are excluded (2) Exclude cases of severe abdominal infection (3) Exclude cases of severe imbalance of the proximal and distal intestinal canal of the anastomosis (such as intestinal atresia)
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: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: experimental group
The patients in the experimental group would be given early oral feeding within 24-48 hours after intestinal anastomosis.
Start taking it at 24-48 hours after surgery until discharged.
The initial dose is 1ml/kg.h,
which is gradually increased to 100ml/kg daily.
|
The patients in the experimental group were fed orally within 24-48 hours after intestinal anastomosis.
Start taking it at 24-48 hours after surgery until discharged.
The initial dose is 1ml/kg.h,
which is gradually increased to 100ml/kg daily.
|
No Intervention: control group
The control group would be given early oral feeding within 4-5 days after intestinal anastomosis.
Start taking it at 4-5 days after surgery until discharged.
The initial dose is 1ml/kg.h,
which is gradually increased to 100ml/kg daily.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Anastomotic leakage or poor anastomotic healing
Time Frame: 1-7days after early oral feeding
|
Feces flow out from the site of the anastomosis into the abdominal cavity
|
1-7days after early oral feeding
|
Gastrointestinal symptoms:nausea, vomiting, diarrhea, abdominal pain and abdominal distent.
Time Frame: 1-14days after early oral feeding
|
There may be some unexpected symptoms happen after early oral feeding after anastomosis such as Nausea, vomiting, diarrhea, abdominal pain and abdominal distent.
|
1-14days after early oral feeding
|
indexs of stress:C-reactive protein, interleukin 6, cortisol
Time Frame: The first day and third day after early oral feeding
|
Some indexs could be defined as indicators of the severity of the stress response
|
The first day and third day after early oral feeding
|
indexs of nurtrion:weight, serum albiumin,serum prealbumin and serum retinol binding protein
Time Frame: The seventh day after anastomosis
|
Some indexs could be defined as indicators of the nutriton status
|
The seventh day after anastomosis
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
indexs of recovery after surgery:Time to first bowel movement, time to use intravenous nutrition and total postoperative hospital stay
Time Frame: 1-14 days after surgery.
|
Some indexs could be defined as indicators of recovery after surgery.
|
1-14 days after surgery.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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)
August 1, 2020
Primary Completion (Actual)
August 1, 2022
Study Completion (Actual)
August 31, 2022
Study Registration Dates
First Submitted
July 6, 2020
First Submitted That Met QC Criteria
July 7, 2020
First Posted (Actual)
July 9, 2020
Study Record Updates
Last Update Posted (Actual)
December 13, 2022
Last Update Submitted That Met QC Criteria
December 10, 2022
Last Verified
December 1, 2022
More Information
Terms related to this study
Other Study ID Numbers
- NanjingCH
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
IPD Plan Description
The data of the study would be shared with othe researchers.
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.
Clinical Trials on Infant
-
University of Colorado, DenverNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); Colorado... and other collaboratorsCompletedInfant Growth | Infant Gut Microbiome | Infant Body FatUnited States
-
Société des Produits Nestlé (SPN)RecruitingInfant Development | Growth and Development | Infant Health | Infant Formula | Infant Nutritional Physiological PhenomenaSaudi Arabia
-
Christiana Care Health ServicesCompletedInfant | Infant, Premature | Infant, Preterm | Infant, LateUnited States
-
University of ArizonaMead Johnson NutritionRecruiting
-
University of ManitobaJohns Hopkins University; University Health Network, Toronto; University of California... and other collaboratorsRecruitingMaternal Health | Infant Growth | Infant NutritionCanada
-
NestléCompletedInfant Formula | Infant Nutritional Physiological PhenomenaSaudi Arabia
-
Yeditepe UniversityCompletedInfant Behavior | Infant Development | Early Intervention | TemperamentTurkey
-
University of Southern CaliforniaCompletedInfant Conditions | Infant Development | Infant, Very Low Birth Weight | Infant, Small for Gestational Age | Infant,PrematureUnited States
-
Bandim Health ProjectUniversity of Southern DenmarkCompleted
-
Nutricia ResearchTerminatedInfant Growth | Parent and Infant User ExperienceNetherlands
Clinical Trials on early oral feeding or early enteral nurtrion
-
Lady Hardinge Medical CollegeAll India Institute of Medical Sciences, New DelhiCompletedTime for Achievement of Full Feeds
-
Shaare Zedek Medical CenterCompleted
-
Lady Hardinge Medical CollegeRecruitingEnteral Feeding Intolerance | Very Preterm Maturity of InfantIndia
-
Lady Hardinge Medical CollegeCompletedNutrition of Preterm InfantsIndia
-
Queensland Centre for Gynaecological CancerThe University of Queensland; Cancer Australia Priority-driven Collaborative...CompletedFallopian Tube Cancer | Epithelial Ovarian Cancer | Peritoneal CancerAustralia
-
Assiut UniversityUnknownPost-Gastrointestinal Tract Surgery Malnutrition
-
McMaster Children's HospitalCompletedPreterm Infants | Nutrition | Early Enteral Feeding AdvancementCanada
-
Jagiellonian UniversityUnknown
-
The Catholic University of KoreaCompleted
-
Yin LiCompleted