Gastric Feeding for the Prevention of Stroke-Associated Pneumonia (FEED-SAP)
Comparing Early Post-pyloric Feeding Versus Gastric Feeding for the Prevention of Stroke-Associated Pneumonia in Patients With Severe Ischemic Stroke
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Descripción detallada
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- Fase 4
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Yahui Guo, MD
- Número de teléfono: +86 13951834652
- Correo electrónico: 1185626794@qq.com
Copia de seguridad de contactos de estudio
- Nombre: Rui Liu, MD
- Número de teléfono: +86 15005144515
- Correo electrónico: liurui8616@163.com
Ubicaciones de estudio
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Jiangsu
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Nanjing, Jiangsu, Porcelana, 210002
- Jinling Hospital, Medical School of Nanjing University, Nanjing
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Contacto:
- Yahui Guo, MD
- Número de teléfono: +86 13951834652
- Correo electrónico: 1185626794@qq.com
-
Contacto:
- Rui Liu, MD
- Número de teléfono: +86 15005144515
- Correo electrónico: liurui8616@163.com
-
Sub-Investigador:
- Yahui Guo, MD
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-
Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
- Niño
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Descripción
Inclusion Criteria:
- Age ≥ 18 years
- Diagnosis of severe ischemic stroke, with NIHSS score > 16 [15-16]
- Confirmed dysphagia via swallowing assessment (Kubota Water Swallowing Test ≥ grade 3, or confirmed aspiration risk by FEES/VFSS)
- Time from onset to enrollment ≤ 72 hours
- Expected survival ≥ 7 days
- Non-mechanically ventilated patients
- Signed informed consent from patient or legal representative.
Exclusion Criteria:
- Diagnosed with pneumonia upon admission
- High risk of gastrointestinal bleeding or perforation
- Intestinal obstruction or gastrointestinal obstruction
- Severe liver or kidney dysfunction
- Advanced malignant tumor
- Pregnancy or breastfeeding
- Refusal to participate in the study
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Prevención
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
|---|---|
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Experimental: Post-Pyloric Feeding Group
A nasoenteric tube (Nuritia, 10Fr) will be placed within 24 hours of admission.
The procedure involves elevating the head of the bed to approximately 30-45°, lubricating the tube with liquid paraffin, inserting it into the stomach using a blind insertion technique, then positioning the patient in the right lateral decubitus position.
The insertion length will be approximately 75 cm.
200-500 ml of air and warm water will be injected into the stomach to open the pylorus.
Gently, as the pylorus opens, the tube will be advanced beyond the ligament of Treitz.
Digestive fluid will be aspirated for pH testing.
Tube position (post-pyloric) will be confirmed by X-ray before initiating enteral nutrition support.
An appropriate nutritional formula will be selected based on the patient's condition.
The initial infusion rate will be 20 ml/h using a nutrition pump.
The head of the bed will be elevated to 30-45°.
Observation will occur continuously for the first hour, then every 4 hours.
The rate wi
|
A nasoenteric tube (Nuritia, 10Fr) will be placed within 24 hours of admission.
The procedure involves elevating the head of the bed to approximately 30-45°, lubricating the tube with liquid paraffin, inserting it into the stomach using a blind insertion technique, then positioning the patient in the right lateral decubitus position.
The insertion length will be approximately 75 cm.
200-500 ml of air and warm water will be injected into the stomach to open the pylorus.
Gently, as the pylorus opens, the tube will be advanced beyond the ligament of Treitz.
Digestive fluid will be aspirated for pH testing.
Tube position (post-pyloric) will be confirmed by X-ray before initiating enteral nutrition support.
An appropriate nutritional formula will be selected based on the patient's condition.
The initial infusion rate will be 20 ml/h using a nutrition pump.
The head of the bed will be elevated to 30-45°.
Observation will occur continuously for the first hour, then every 4 hours.
The rate wil
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Comparador activo: Gastric Feeding Group
A nasogastric tube (Nuritia, 14Fr) will be placed within 24 hours of admission.
The tube will be lubricated with liquid paraffin, inserted into the gastric cavity using a blind insertion technique, and properly fixed.
Correct position will be confirmed by auscultation of air insufflation over the stomach before initiating enteral nutrition support.
An appropriate nutritional formula will be selected based on the patient's condition.
The initial infusion rate will be 20 ml/h using a nutrition pump.
The head of the bed will be elevated to 30-45°.
Observation will occur continuously for the first hour, then every 4 hours.
The rate will be gradually increased by 10 mL every 4 hours based on patient tolerance until the daily target volume (25-30 kcal/kg/day) is achieved.
|
A nasogastric tube (Nuritia, 14Fr) will be placed within 24 hours of admission.
The tube will be lubricated with liquid paraffin, inserted into the gastric cavity using a blind insertion technique, and properly fixed.
Correct position will be confirmed by auscultation of air insufflation over the stomach before initiating enteral nutrition support.
An appropriate nutritional formula will be selected based on the patient's condition.
The initial infusion rate will be 20 ml/h using a nutrition pump.
The head of the bed will be elevated to 30-45°.
Observation will occur continuously for the first hour, then every 4 hours.
The rate will be gradually increased by 10 mL every 4 hours based on patient tolerance until the daily target volume (25-30 kcal/kg/day) is achieved.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Incidence of stroke-associated pneumonia within 7 days of onset
Periodo de tiempo: 7 days of onset.
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The diagnostic criteria for SAP will follow the 2019 Chinese Expert Consensus on the Diagnosis and Treatment of Stroke-Associated Pneumonia.
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7 days of onset.
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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Hospital length of stay
Periodo de tiempo: From date of admission to date of discharge, assessed up to 28 days
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Length of patients stay in the hospital
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From date of admission to date of discharge, assessed up to 28 days
|
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90-day modified Rankin Scale (mRS) score
Periodo de tiempo: 90 days after randomization
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The distribution of the 90-day mRS (0;1;2;3;4;5;6) as assessed by structured assessment.
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90 days after randomization
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Time from admission to achieving enteral nutrition target
Periodo de tiempo: From date of admission until enteral nutrition target is achieved, assessed up to 28 days
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Enteral nutrition target is set as 25-30kcal/kg.
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From date of admission until enteral nutrition target is achieved, assessed up to 28 days
|
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Change from baseline in serum albumin level at Day 14
Periodo de tiempo: Baseline and Day 14
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Serum albumin will be measured via venous blood sample.
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Baseline and Day 14
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Change from baseline in serum albumin level at Day 28
Periodo de tiempo: Baseline and Day 28
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Serum albumin will be measured via venous blood sample
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Baseline and Day 28
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Change from baseline in white blood cell count at Day 14
Periodo de tiempo: Baseline and Day 14
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White blood cell count will be measured via venous blood sample.
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Baseline and Day 14
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Change from baseline in white blood cell count at Day 28
Periodo de tiempo: Baseline and Day 28
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White blood cell count will be measured via venous blood sample.
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Baseline and Day 28
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Otras medidas de resultado
Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Mortality within 28 days
Periodo de tiempo: 28 days post-randomization.
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Percentage of patients who die within 28 days post-randomization.
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28 days post-randomization.
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Incidence of Gastrointestinal Complications
Periodo de tiempo: 28 days
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Gastrointestinal bleeding, diarrhea, abdominal distension, constipation, vomiting.
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28 days
|
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Catheter-related Complications
Periodo de tiempo: 28 days
|
Blockage, displacement, dislodgement
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28 days
|
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Change from baseline in serum total protein level at Day 14
Periodo de tiempo: Baseline and Day 14
|
Serum total protein level will be measured via venous blood sample.
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Baseline and Day 14
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Change from baseline in serum prealbumin level at Day 14
Periodo de tiempo: Baseline and Day 14
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Serum prealbumin level will be measured via venous blood sample.
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Baseline and Day 14
|
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Change from baseline in serum transferrin level at Day 14
Periodo de tiempo: Baseline and Day 14
|
Serum transferrin level will be measured via venous blood sample.
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Baseline and Day 14
|
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Change from baseline in serum total protein level at Day 28
Periodo de tiempo: Baseline and Day 28
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Serum total protein will be measured via venous blood sample
|
Baseline and Day 28
|
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Change from baseline in serum prealbumin level at Day 28
Periodo de tiempo: Baseline and Day 28
|
Serum prealbumin will be measured via venous blood sample
|
Baseline and Day 28
|
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Change from baseline in serum transferrin level at Day 28
Periodo de tiempo: Baseline and Day 28
|
Serum transferrin will be measured via venous blood sample
|
Baseline and Day 28
|
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Change from baseline in C-reactive protein level at Day 14
Periodo de tiempo: Baseline and Day 14
|
C-reactive protein will be measured via venous blood sample.
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Baseline and Day 14
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Change from baseline in interleukin-6 level at Day 14
Periodo de tiempo: Baseline and Day 14
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Interleukin-6 level will be measured via venous blood sample.
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Baseline and Day 14
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Change from baseline in body temperature at Day 14
Periodo de tiempo: Baseline and Day 14
|
Body temperature will be recorded at 8:00 AM daily during the hospitalization.
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Baseline and Day 14
|
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Change from baseline in interleukin-6 level at Day 28
Periodo de tiempo: Baseline and Day 28
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Interleukin-6 level will be measured via venous blood sample.
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Baseline and Day 28
|
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Change from baseline in C-reactive protein level at Day 28
Periodo de tiempo: Baseline and Day 28
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C-reactive protein level will be measured via venous blood sample.
|
Baseline and Day 28
|
|
Change from baseline in body temperature at Day 28
Periodo de tiempo: Baseline and Day 28
|
Body temperature will be recorded at 8:00 AM daily during the hospitalization.
|
Baseline and Day 28
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Wusheng Zhu, MD, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
Otros números de identificación del estudio
- FEED-SAP
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Información sobre medicamentos y dispositivos, documentos del estudio
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