- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT00580749
Study of Nutrition in Acute Pancreatitis (SNAP)
26. januar 2016 oppdatert av: David Whitcomb, University of Pittsburgh
Feeding and Pancreatic Rest in Acute Pancreatitis
We will compare the two types of enteral (intestinal) nutrition in regard to patients with severe acute pancreatitis in our institution and also in 8 others in the United States.
Studieoversikt
Status
Avsluttet
Forhold
Intervensjon / Behandling
Studietype
Intervensjonell
Registrering (Faktiske)
23
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
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Alabama
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Birmingham, Alabama, Forente stater, 35294
- University of Alabama
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Florida
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Gainesville, Florida, Forente stater, 32610
- University of Florida College of Medicine
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Indiana
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Indianapolis, Indiana, Forente stater, 46202
- Indiana University
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Pennsylvania
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Pittsburgh, Pennsylvania, Forente stater, 15261
- University of Pittsburgh Medical Center
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
- Patients over the age of 18yr
- The typical history of abdominal pain for over 24h with raised (>3-fold) serum pancreatic enzymes on admission
Severe pancreatitis, as defined by: the Atlanta classification of severe disease (60), but with important modifications to sharpen the definition of severity, to include one or more of the following:
- The presence of organ failure (MOF) resistant to early aggressive IV fluid resuscitation as defined by a Marshall score of ≥2 in any one organ (for calculation, see Appendix (61)), excluding the liver component as the abnormality may be due to gall stones rather than the systemic inflammatory response (17)
- Pancreatic necrosis >30% on CT scan or a modified CT severity index (CTSI: see Appendix (62)) of ≥8
- APACHE score ≥ 8 (for calculation, see Appendix (63))
- Ranson's criteria ≥3 (for calculation, see Appendix (64))
Exclusion Criteria:
- Inability to absorb enteral nutrients resulting in chronic intestinal failure and need for IV feeding, such as short bowel, malabsorption disorders such as celiac or intestinal proliferative disorders, chronic obstruction and pseudo-obstruction.
- Time elapse since commencement of acute pancreatitis symptoms >10 days. In order to take advantage of the 'window of opportunity' to prevent the progression of 'transient' MOF to 'permanent' MOF, patients should be started on enteral feeding as soon as possible. However, in practice many patients present initially with mild disease which progresses to severe necrosis at the end of the first week, and these patients need nutritional support for long periods of time. Consequently, this is an important group to include in this investigation. Post hoc analysis will be performed to see whether they behave differently to patients fed earlier in their disease
- Any form of artificial feeding since commencement of acute pancreatitis symptoms
- Patients with chronic pancreatitis and pancreatic insufficiency requiring pancreatic enzyme supplements, based on clinical history and specific investigations such as by ERCP, MRP, or CT scanning.
- Pre-existing chronic renal insufficiency requiring hemodialysis or peritoneal dialysis, as this will make assessment of severity difficult
- Pre-existing end-stage liver disease with ascites, coagulopathy and encephalopathy, supported by biopsy, and/or radiological imaging and endoscopy (portal hypertension, varices and gastropathy), as this will make assessment of severity difficult
- Chronic immunodeficiency states such as AIDS defined by CD-4 count < 50, and immunoglobulin deficiencies as it may independently affect feeding tolerance and infection risk
- Pancreatic cancer proven by biopsy, and any other form of cancer with life-expectancy <6 months.
- Current somatostatin or corticosteroid therapy as these drugs will impair intestinal, metabolic, and immune function, and therefore affect absorption and infection risk.
- Contraindication to using the nose for enteral tube insertion
- Severe traumatic brain injury with ICP>20mmHg despite treatment
- Previous completion or withdrawal from this study
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
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Aktiv komparator: DJ
Naso disal jejunal(DJ) feedings randomized to 50% of subjects meeting criteria.
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Placement of feeding tube through nare and into jejunum for administration of enteral feeding.
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Aktiv komparator: NG
Placement of naso gastric feeding tube through nare into stomach for enteral feeding.
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Placement of naso gastric feeding tube into stomach for purpose of enteral feedings.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tidsramme |
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Feeding success as determined by the quantity of nutrition delivered and the number of interruptions due to intolerance and how the two forms of feeding influence disease outcome as measured by duration of ICU and hospital stay.
Tidsramme: Approx. one week
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Approx. one week
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Sekundære resultatmål
Resultatmål |
Tidsramme |
---|---|
Feeding tolerance (nitrogen balance, stool volume, incidence of nausea, incidence of nausea and vomiting) will demonstrate better tolerance for subjects undergoing DJ feeding than those undergoing NG feeding.
Tidsramme: Approx. one week
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Approx. one week
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: David Whitcomb, MD, University of Pittsburgh
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart
1. januar 2010
Primær fullføring (Faktiske)
1. mai 2013
Studiet fullført (Faktiske)
1. mai 2013
Datoer for studieregistrering
Først innsendt
21. desember 2007
Først innsendt som oppfylte QC-kriteriene
26. desember 2007
Først lagt ut (Anslag)
27. desember 2007
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
27. januar 2016
Siste oppdatering sendt inn som oppfylte QC-kriteriene
26. januar 2016
Sist bekreftet
1. juni 2013
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- PRO 07080011, PRO 07080044
- 1 R01 DK 075803-01A1 NIH#
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .
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