TICACOS International (P2 -RMCS)
Tight Caloric Balance in ICU Patients: a Multicenter, Prospective, Randomized, Controlled Study.
The aim of this study is to perform a prospective, randomized, controlled blinded study in critically patients to assess the necessity for measuring daily resting energy expenditure as a guide for nutritional support. Our hypothesis is that tight caloric control will reduce the rate of new infections.
Study Design :Multi-center, randomized, single blinded, controlled study. Study Population: newly-admitted, adult mechanically ventilated ICU patients.
研究概览
详细说明
Study objectives
To evaluate the effect of tight caloric control in critical patients on:
- The rate of acquired nosocomial infections (Ventilated associated pneumonia, Catheter related infections, Urinary tract infections)
- Mortality rates, length of stay in the ICU and in hospital, length of ventilation and incidence of non-infectious complications.
Primary endpoint:
Rate of nosocomial infections (for definitions see appendage 1) acquired after 48 to 72 hours following admission.
Secondary endpoints
- Metabolic control: glucose concentration, insulin administration, rate of hypoglycemic events.
- Success of tight caloric control: accumulative and maximum negative energy balance.
- Organ function: SOFA score.
- Rate of non-infectious complications: requirement for surgery or occurrence of pressure sores.
- Length of ICU stay and of assisted ventilation (LOS and LOV)
- ICU survival rate.
- Patient status and disposition on day 28 or at hospital discharge.
- 3 & 6 months survival.
研究类型
注册 (预期的)
阶段
- 不适用
联系人和位置
学习地点
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Petach Tikva、以色列、49100
- 招聘中
- Rabin Medical Center, Campus Beilinson
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接触:
- Pierre Singer, Professor,MD
- 电话号码:972-39376521
- 邮箱:psinger@clalit.org.il
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副研究员:
- Ronit Anbar, RD
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接触:
- Milana Grinev, Study Coordinator
- 电话号码:972-39376590
- 邮箱:milang@clalit.org.il
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Mechanically-ventilated adults(Male or Female)admitted to general ICU within the first 48 hours of ICU admission.
- Age ≥ 18 years;no upper age limit.
- Expected stay in ICU> 3 days: [SAPS II (18) > ICU median or high-level of nursing care implemented or per clinical impression of attending physician]
- Medical and abdomino/thoracic surgery patients, as well as multiple trauma patients with Glasgow Coma Score ≥ 10.
Exclusion Criteria:
- Pregnancy.
- DNR order.
- Readmission in the ICU during the same hospitalization/transfer from other ICU.
- Admission for postoperative monitoring.
- Respiratory instability: SpO2 <90% or need for ventilator adjustments during the preceding hour or hyperventilation (Respiratory rate > 35/min)
- Bicarbonate infusion, loss of bicarbonate (diarrhea, ureterosogmoidostomy or use of acetazoloamide, ultrafiltration).
- Aerosolization with nitric oxide or heliox, tracheal insufflations or visible leaks in chest drainage system.
- FiO2 80% or patients requiring prone position
- Chronic/acute liver failure:Child-Pugh class C
- Brain injury for various reasons with Glasgow Coma Scale below 10.
- Cardiac surgery patients.
- Patients in the hospital for more than 7 days.
- Contra indication to use enteral nutrition.
- Participation in a clinical study with an investigational drug within one month prior to the start of this clinical trial.
- Ethical issues that will influence subject eligibility.
学习计划
研究是如何设计的?
设计细节
- 主要用途:诊断
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
无干预:Control group
Patients in this group will receive enteral nutrition/parenteral nutrition or combination of enteral and parenteral nutrition according to the "liberal " regimen, i.e. according to local practice.
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实验性的:Indirect Calorimetry
Study group: Indirect Calorimetry (IC) Patients in this group will receive enteral nutrition/parenteral nutrition or combination of enteral and parenteral nutrition according to the individual energy requirements calculated by Indirect Calorimetry measurement of Resting Energy Expenditure (REE).
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Patients in this group will receive enteral nutrition/parenteral nutrition or combination of enteral and parenteral nutrition according to the individual energy requirements calculated by Indirect Calorimetry.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Rate of nosocomial infections
大体时间:After 48 to 72 hours /daily assessment: within 28 day
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Rate of nosocomial infections acquired after 48 to 72 hours following admission up to day 28/or discharge will be evaluated
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After 48 to 72 hours /daily assessment: within 28 day
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Metabolic control
大体时间:Day 1 up to day 28/or discharge
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Glucose concentration, insulin administration, rate of hypoglycemic events will be daily assessed
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Day 1 up to day 28/or discharge
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Caloric control
大体时间:Day 1 up to day 28/or discharge
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Success of tight caloric control:accumulative and maximum negative energy balance
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Day 1 up to day 28/or discharge
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合作者和调查者
调查人员
- 首席研究员:Pierre Singer, MD, Professor、RabinMC,Beilinson Hospital
- 研究主任:Milana Grinev, RN,Study Coordinator、RabinMC, Beilinson Hospital ,Petah- Tikva, Israel
研究记录日期
研究主要日期
学习开始
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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