- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT07562997
Sodium and Milk Fortification Evaluation of Body Composition Among Very Preterm Infants (SAFE)
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
Very preterm infants (born <32 weeks gestational age) are at high risk for postnatal growth faltering, which is associated with adverse neurodevelopmental outcomes. Despite routine use of enriched human milk fortification in the NICU, many infants fail to achieve adequate somatic and lean mass growth. Sodium depletion has been identified as a potentially modifiable contributor to this problem: renal tubular immaturity in preterm infants results in obligate urinary sodium wasting. Total body sodium depletion has been associated with poor growth in infants and poor muscle mass development in animal studies.
Current NICU practice relies primarily on serum sodium to guide supplementation; however, serum sodium is a late and insensitive marker of total body sodium depletion. Urine sodium is a more sensitive indicator of sodium balance and may identify depletion before serum levels fall. Gestational-age-specific urine sodium thresholds to guide supplementation have recently been proposed (Stalter et al., 2025), but have evaluated body composition in a prospective randomized trial.
This trial tests whether a structured, urine sodium-guided supplementation protocol based on every other week urine and serum sodium monitoring improves anthropometric growth and lean mass accrual compared to standard enriched fortification alone. The intervention runs from day of life 14 through 36 weeks postmenstrual age, with tapering through 38 weeks PMA.
Body composition assessment incorporates two complementary modalities: serial point-of-care ultrasound (POCUS) of the biceps, rectus femoris, and subcutaneous fat for longitudinal lean and fat mass tracking, and Air Displacement Plethysmography (PeaPod) at 36 weeks postmenstrual age or discharge for criterion-standard whole-body composition. Fat mass, fat-free mass, and body fat percentage will be referenced against the Norris et al. preterm normative curves.
The trial uses an open-label design with block randomization stratified by gestational age. A Data Safety and Monitoring Board will conduct oversight and interim safety reviews.
Studientyp
Einschreibung (Geschätzt)
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
- Name: Debbie Ng, MPH
- E-Mail: ngdm@uw.edu
Studieren Sie die Kontaktsicherung
- Name: John Feltner, MS
- Telefonnummer: (206) 543-3200
- E-Mail: jfeltner@uw.edu
Studienorte
-
-
Ohio
-
Cincinnati, Ohio, Vereinigte Staaten, 45221
- Noch keine Rekrutierung
- University of Cincinnati
-
Kontakt:
- Ting Ting Fu, MD
- Telefonnummer: 513-636-4200
- E-Mail: futn@ucmail.uc.edu
-
-
Oregon
-
Portland, Oregon, Vereinigte Staaten, 97239
- Noch keine Rekrutierung
- Oregon Health & Science University
-
Kontakt:
- Brian Scottoline, MD, PhD
- Telefonnummer: (503) 494-8122
- E-Mail: scottoli@ohsu.edu
-
-
Washington
-
Seattle, Washington, Vereinigte Staaten, 98195
- Rekrutierung
- University of Washington
-
Kontakt:
- Katie M Strobel, MD, MSCR
- Telefonnummer: (206) 543-3200
- E-Mail: kmstrob@uw.edu
-
Unterermittler:
- D Taylor Hendrixson, MD, MPH
-
-
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
- Kind
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Admitted to the University of Washington, Oregon Health and Sciences, or University of Cincinnati NICU at 14 days of age
- Born between 24w0days and 31w6d
- Achieved full enteral feeding
Exclusion Criteria:
- Congenital or chromosomal anomalies affecting growth
- Acute renal insufficiency (KDIGO stage 1 or higher)
- Necrotizing enterocolitis (modified Bell's stage IIA or higher)
- Anticipated NICU stay less than 30 days
- Enrollment in a concurrent interventional study that may confound study outcomes
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Single
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Experimental: Targeted sodium supplementation
Every two weeks serum sodium and urine sodium testing with sodium supplementation if indicated by algorithm.
Milk fortification per growth metrics.
|
The investigators will utilize urine sodium testing every two weeks in conjunction with serum sodium testing to determine if sodium supplementation is indicated.
The investigators will use serum sodium testing to determine if sodium supplementation or adjustments to sodium supplementation need to be made.
The investigators will provide milk fortification using either a bovine-based or a human-milk-based fortifier (per unit protocol), based on growth trajectories.
|
|
Aktiver Komparator: Enriched Milk Fortification
Serum sodium testing every two weeks with sodium supplementation if indicated by clinical team.
Milk fortification per growth metrics.
|
The investigators will use serum sodium testing to determine if sodium supplementation or adjustments to sodium supplementation need to be made.
The investigators will provide milk fortification using either a bovine-based or a human-milk-based fortifier (per unit protocol), based on growth trajectories.
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Body composition by point-of-care ultrasound
Zeitfenster: Enrollment to study completion, on average 4-10 weeks
|
Evaluate muscle and subcutaneous fat accretion from enrollment to 36 weeks posmtnestrual age.
The study team will perform biceps and rectus femoris cross-sectional area measurements using point-of-care ultrasound every 2 weeks.
We will perform arm and mid-thigh subcutaneous fat measurements using point-of-care ultrasound every 2 weeks.
|
Enrollment to study completion, on average 4-10 weeks
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Body composition using air-displacement plethysmography
Zeitfenster: At study completion, on average 4-10 weeks
|
We will conduct air-displacement plethysmography when the infant is off of oxygen at 36 weeks postmenstrual age or prior to discharge, whichever comes earlier.
|
At study completion, on average 4-10 weeks
|
Andere Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Anthropometric growth
Zeitfenster: Enrollment to study completion, on average 4-10 weeks
|
The clinical team measures weight, length, and head circumference z-scores weekly during hospitalization.
The investigators will evaluate the change in z-score from birth to 36 weeks postmenstrual age
|
Enrollment to study completion, on average 4-10 weeks
|
|
Adverse outcomes
Zeitfenster: Enrollment to hospital discharge, on average between 4 to 16 weeks
|
The study team will evaluate adverse outcome rates such as bronchopulmonary dysplasia, necrotizing enterocolitis, and all-cause mortality.
|
Enrollment to hospital discharge, on average between 4 to 16 weeks
|
Mitarbeiter und Ermittler
Sponsor
Ermittler
- Hauptermittler: Katie Strobel, MD, MSCR, University of Washington
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Andere Studien-ID-Nummern
- STUDY00023657
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
Beschreibung des IPD-Plans
IPD-Sharing-Zeitrahmen
Art der unterstützenden IPD-Freigabeinformationen
- CSR
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Produkt, das in den USA hergestellt und aus den USA exportiert wird
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .
Klinische Studien zur Urine sodium testing
-
University of Texas at AustinTexas Tech University Health Sciences Center, El PasoRekrutierungHumanes Papillomavirus (HPV) | GebärmutterhalskrebsVereinigte Staaten
-
Central Denmark RegionRekrutierungPoint-of-Care-Tests | Medizinischer Notfalldienst vor dem Krankenhaus | Präklinische NotfallversorgungDänemark
-
Washington University School of MedicineThe Foundation for Barnes-Jewish HospitalBeendetLynch-Syndrom | Erblicher Brust- und EierstockkrebsVereinigte Staaten
-
Eastern Hepatobiliary Surgery HospitalNoch keine RekrutierungFortgeschrittener Gallengangskrebs (BTC)
-
Wake Forest University Health SciencesAbgeschlossen
-
Josip Juraj Strossmayer University of OsijekAbgeschlossenDiabetes mellitus, Typ 2 | Nicht alkoholische FettleberKroatien
-
Misook L. ChungAbgeschlossen
-
St George's, University of LondonAbgeschlossenPost HerzchirurgieVereinigtes Königreich
-
Northwell HealthGenomind, LLCAbgeschlossenPsychotische Störungen | Schizophrenie | Schizoaffektiven Störung | Schizophreniforme Störung | Bipolare StörungVereinigte Staaten
-
San Diego State UniversityNational Cancer Institute (NCI)Abgeschlossen