Nutrition Practice in Critically Ill Adults (NUTRIENT)

Nutrition Practice in Critically Ill Adults - an Observational Study

To determine the role of nutrition in recovery from critical illness, current practice must first be understood. However, no benchmarking process currently exists for nutrition practice during critical illness, from ICU admission to hospital discharge. This vital gap requires addressing.

The aim of this study is to inform and re-design models of nutrition care and generate research priorities for the future by obtaining data on nutrition provision and practice and that of consumer preference for nutrition care.

Study Overview

• Status: Recruiting
• Conditions: Critical Illness
• Intervention / Treatment: Other: No intervention

Detailed Description

This study is a multi-centre observational study of nutrition practices in critically ill adults across ANZ. Two study periods are proposed, the first confirmed period in Q3-2024 and the second in 2026.

This study is part of a larger study which consists of three interconnected streams. This study forms part of Stream 2 which is about understanding nutrition practice and provision in adults with critical illness. The findings from this study will be used to inform the development and implementation of new models of nutrition care for adults with critical illness.

On the day of study commencement (day 1), all patients treated in the ICU and admitted to the ICU after 00:00 will be screened for eligibility. Observational data will be collected days 1 and 3 of their ICU stay (whilst present in ICU) and then days 7, 14, 21 and 28 (whether they are in ICU or the ward) as well as the first full day on the ward (day after ICU discharge).

At the completion of the project, the investigators will hold the largest sample of nutrition care in critical illness in Australia (approximately 1200 Adult patients including the pilot data period) and the only international database to include the period after ICU discharge. This proposal directly links with the National Safety and Quality Health Service (NSQHS) Standard 5 (Comprehensive Care) and Standard 2 (Partnering with Consumers) and will rapidly provide data about nutrition care and hospital acquired malnutrition (a serious reportable consequence under Standard 5) to inform the accreditation process and provide a risk mitigation strategy to prevent malnutrition before it occurs. This data will be used to improve and re-design nutrition care, as well as generate new research priorities that are highly relevant to issues within clinical care, with the potential to save millions of dollars in healthcare expenditure nationally.

• Study Type: Observational
• Enrollment (Estimated): 600

Contacts and Locations

• Study Contact: Name: Emma Ridley, A/Prof; Phone Number: +61 3 9903 0350; Email: nutrient@monash.edu

Study Locations

• Australia
  • Victoria
    • Melbourne, Victoria, Australia, 3004
      • Recruiting
      • Monash University
      • Contact: Tina van Tonder; Email: nutrient@monash.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

In a 7 day study period, all adult patients present in the ICU who meet all of the inclusion criteria and no exclusion criteria will be included.

Description

Inclusion Criteria:

1. Age 18 years or older
2. Admitted to ICU after 00:00 on the date of study commencement
3. Remain in ICU for ≥ 48 hours

Exclusion Criteria:

1. Patients who have been deemed ready to be discharged by the treating team within 48 hours of ICU admission but have not been able to be discharged within 48 hours of ICU admission for logistical reasons (e.g., due to bed unavailability, inability to return home)
2. Patients who have been admitted for palliative care or organ donation or made palliative within 48 hours of ICU admission

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nutritional outcomes	Protein and energy prescription and provision	Up to day 28 of hospitalization
Nutritional outcomes	Use of Enteral Nutrition (EN)	Up to day 28 of hospitalization
Nutritional outcomes	Parenteral Nutrition (PN)	Up to day 28 of hospitalization
Nutritional outcomes	Oral intake and oral nutrition supplements	Up to day 28 of hospitalization
Nutrition service delivery in the ICU and ward setting	Levels of staffing available and service provision for nutrition care in the ICU and on the ward	Up to day 28 of hospitalization
Descriptions of nutrition prescription, delivery and service variability across ANZ	Comparison of nutrition care between participating hospitals	Up to day 28 of hospitalization
Patient-centred outcomes	Duration of hospital stay	Up to day 28 of hospitalization
Patient-centred outcomes	Mortality	Up to day 28 of hospitalization
Patient-centred outcomes	Discharge destination	Up to day 28 of hospitalization

Collaborators and Investigators

• Sponsor: Australian and New Zealand Intensive Care Research Centre

Study record dates

Study Major Dates

• Study Start (Actual): August 26, 2024
• Primary Completion (Estimated): December 31, 2027
• Study Completion (Estimated): December 31, 2027

Study Registration Dates

• First Submitted: August 14, 2024
• First Submitted That Met QC Criteria: August 27, 2024
• First Posted (Actual): August 29, 2024

Study Record Updates

• Last Update Posted (Estimated): December 2, 2024
• Last Update Submitted That Met QC Criteria: November 27, 2024
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Keywords: Nutrition; Intensive Care
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Critical Illness
• Other Study ID Numbers: ANZIC-RC/ER002

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
• product manufactured in and exported from the U.S.: No