Impact of a High-Protein Diet on Clinical Outcomes in Mechanically Ventilated Patients With Severe Pneumonia
調査の概要
詳細な説明
prospective, comparative, observational study will be conducted at the Critical Care Department, Fayoum University Hospital, aims to evaluate the effect of a high-protein diet on clinical outcomes in mechanically ventilated patients with severe pneumonia, focusing on muscle preservation and weaning ability. The specific objectives are:
- To assess the impact of high-protein intake on skeletal muscle mass using quadriceps ultrasound.
- To evaluate diaphragmatic function and thickness in relation to protein intake using ultrasound.
- To determine the effect of high-protein nutrition on weaning success, duration of mechanical ventilation, length of hospital stay and mortality.
研究の種類
入学 (推定)
連絡先と場所
研究場所
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Faiyum Governorate
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Al Fayyum、Faiyum Governorate、エジプト、63514
- Faculty of medicine Fayoum university
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Age ≥ 18 years.
- Mechanically ventilated patients with severe pneumonia.
- Expected ICU stay ≥ 72 hours.
Exclusion Criteria:
- Patients who died before 72 hours of ICU admission.
- Chronic liver failure or decompensated cirrhosis.
- End-stage renal disease (CKD stage 5 or dialysis dependent).
- Neuromuscular diseases or pre-existing severe muscle wasting.
- Pregnancy.
- Patients with pre-existing malnutrition (e.g., BMI <18.5 kg/m² ).
Contraindications to enteral feeding, such as:
- Mechanical bowel obstruction.
- Severe gastrointestinal bleeding.
- High-output fistulas involving the gastrointestinal tract.
- Recent gastrointestinal surgery preventing enteral access.
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
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High-protein group
Group of mechanically ventilated patients with severe pneumonia that will receive Protein intake 2.0 g/kg/day.
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Standard-protein group
Group of mechanically ventilated patients with severe pneumonia that will receive Protein intake 1.2 g/kg/day.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Duration of mechanical ventilation
時間枠：From enrollment to the end of treatment at 1 to 2 weeks
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The total time in days during which the patient receives invasive mechanical ventilatory support through an endotracheal tube or tracheostomy, calculated from the initiation of mechanical ventilation until successful liberation from the ventilator or death.
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From enrollment to the end of treatment at 1 to 2 weeks
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Weaning Success
時間枠：1 to 2 weeks
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Successful discontinuation of mechanical ventilatory support with maintenance of spontaneous breathing after extubation, without the need for re-intubation, reinstitution of invasive mechanical ventilation, or death within 48 hours.
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1 to 2 weeks
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Preservation of Quadriceps Muscle Mass Assessed by Ultrasound
時間枠：2 weeks
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Preservation of quadriceps muscle mass was assessed using bedside ultrasonography by measuring the quadriceps muscle thickness at predefined anatomical landmarks.
Muscle preservation was defined as the percentage change in muscle thickness from baseline to the follow-up assessment, with a smaller reduction indicating better preservation of muscle mass.
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2 weeks
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Diaphragm Muscle Thickness Assessed by Ultrasound
時間枠：2 weeks
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Diaphragm muscle thickness was assessed using bedside ultrasonography in the zone of apposition of the diaphragm. The thickness of the diaphragm measured by ultrasound at the zone of apposition, expressed in millimeters (mm). Measurements were obtained at end-expiration, and the percentage change from baseline was used to assess diaphragm muscle preservation or atrophy. Diaphragm Thickening Fraction (DTF) (%)=(DT at end-inspiration - DT at end-expiration) ÷ DT at end-expiration × 100. TF ≥ 20% is considered normal; < 20% suggests diaphragmatic dysfunction. |
2 weeks
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Incidence of ICU-Acquired Weakness
時間枠：1 to 4 weeks
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The percentage of patients who develop ICU-acquired weakness during ICU admission.
ICU-AW was diagnosed when the MRC sum score was <48/60 during ICU admission.
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1 to 4 weeks
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ICU Length of Stay
時間枠：2 to 4 weeks
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The number of days spent in the ICU, calculated from ICU admission to ICU discharge, transfer to another ward, or death during ICU stay.
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2 to 4 weeks
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Mortality
時間枠：2 to 4 weeks
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The proportion of patients who die during their ICU stay, calculated from ICU admission until ICU discharge.
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2 to 4 weeks
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協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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