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Olive Oil and Soybean 1 Oil Based Intravenous Lipid Emulsions, Liver Chemistry and Clinical Outcomes
Olive Oil and Soybean 1 Oil Based Intravenous Lipid Emulsions, Liver Biochemistry and Clinical Outcomes
Background: Intravenous lipid emulsions (IVLE) are an essential component of parenteral nutrition (PN). Omega-6 reducing strategies may improve outcomes, including reduced PN associated liver disease.
Objective: The primary objective was to compare serum alkaline phosphatase (ALP), among surgical and medical patients provided with either Intralipid or Clinoleic lipid emulsions.
Design: In this quasi-experimental study the medical records of surgical and medical adult patients were reviewed from 3 Canadian hospitals that received PN with either soybean oil (Intralipid) or predominantly olive oil (Clinoleic) based lipid emulsions for at least 7 consecutive days.
Visão geral do estudo
Status
Descrição detalhada
A few small studies have shown that a predominantly olive oil based IVLE is well tolerated and safe, however the clinical relevance of this IVLE is uncertain as no clear benefit in outcomes has been observed in small randomized clinical trials. Given the limited data available for the adult population reporting on the experience with olive oil based IVLE, we designed a quasi-experimental study to review our experience with Clinoleic compared to Intralipid. The primary objective was to compare the impact of Intralipid and Clinoleic IVLE on serum alkaline phosphatase (ALP), pre-PN to after one week of PN (i.e. between day 8 to 16 post-PN initiation), while controlling for the ordered lipid dosing. Secondary objectives were to assess if there were differences between the IVLEs on the remaining liver function tests, lipid dosing, incidence of infectious complications, length of stay in hospital and 30- day mortality.
This retrospective quasi-experimental chart review was conducted in 3 tertiary care hospitals in Calgary, AB between July 01, 2012 to June 30, 2013 and July 01, 2014 to June 30, 2015. Standard soybean oil-based therapy, Intralipid was the only available IVLE in Calgary, AB until July 2013, at which time predominantly olive oil Clinoleic was approved as an alternative in the hospital formulary, accounting for the dates chosen for the study. Ethics approval from the Conjoint Health Research and Ethics Board at the University of Calgary was obtained prior to the initiation of the study.
Tipo de estudo
Inscrição (Real)
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Método de amostragem
População do estudo
Descrição
Inclusion Criteria:
- admitted to hospital who received PN with Intralipid or Clinoleic IVLEs for at least 7 consecutive days.
Exclusion Criteria:
- baseline liver disease
- home PN prior to admission
- ALP and total bilirubin (TB) not available within 3 days prior to PN start as well as between days 8 to 16 post PN start
- receipt of Diprivan 1%® (Propofol 116 - AstraZeneca Canada Inc., Mississauga, Canada) during PN support period
- enteral nutrition providing greater than 600 Kcal daily for longer than half of time period on PN
- oral intake of greater than 50% of hospital meal tray contents for longer than half of the PN support time period
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
---|
Intralipid
Standard soybean oil-based therapy
|
Clinoleic
Olive oil based therapy
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Serum ALP Level
Prazo: 8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Serum ALT
Prazo: 8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
Serum GGT
Prazo: 8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
Serum TB
Prazo: 8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
Serum BD
Prazo: 8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
Serum TG
Prazo: 8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
IVLE prescriptions dosing
Prazo: Day 3 to 16 after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
Day 3 to 16 after PN initiation
|
All cause mortality
Prazo: By 30 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
By 30 days after PN initiation
|
Length of hospital stay
Prazo: During PN Period
|
Difference between Intralipid and Clinoleic groups
|
During PN Period
|
Infectious complications incidence
Prazo: During PN Period
|
Difference between Intralipid and Clinoleic groups
|
During PN Period
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Maitreyi Raman, University of Calgary
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- AJCN Raman
Plano para dados de participantes individuais (IPD)
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