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Effects of Delayed Enteral Nutrition on Inflammatory Responses and Immune Function Competence in Critically Ill Patients With Prolonged Fasting

Phase 3
Completed
Conditions
Severe Acute Pancreatitis Patients
Duodenal Fistula
Inflammatory Intestinal Obstruction
Interventions
Dietary Supplement: enteral nutrition
Registration Number
NCT01834430
Lead Sponsor
Nanjing PLA General Hospital
Brief Summary

Different studies suggest that early enteral nutrition (EEN) has benefits in reducing infectious complications, there is no data that addresses whether delayed enteral nutrition (EN) is detrimental and if it may have effects on inflammatory responses and immune function.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
45
Inclusion Criteria
  • having a fasting time of more than 14 days
  • American Society of Anesthesiologists (ASA) physical status ranging between 1 and 3, and their condition allows enteral nutrition therapy.
Exclusion Criteria
  • chronic renal failure (peritoneal or hemodialysis or creatinine > 2.5 mg/dl)
  • history of chronic obstructive pulmonary disease
  • hepatic dysfunction or cirrhosis or a bilirubin value > 3 mg/dl
  • metabolic diseases,severe anemia
  • blood coagulation dysfunction
  • pregnancy lactation
  • history of psychiatric illness
  • patients underwent immunosuppressive therapy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
EN groupenteral nutritionThe EN group gradually restored enteral nutrition, while the PN group continued to receive parenteral nutrition treatment. Both groups received between 20 to 25 kcal/kg/day and 1.5 g/kg/day of protein. Because of the low volume, concentration, and calorie amount, on the first day, tube feeding utilized 500 ml with the speed of 30 \~ 50 ml/h. On the second day, tube feeding utilized 1000 ml with the speed of 60 \~ 80 ml/h. On the third day, tube feeding utilized 1500 \~ 2000 ml with the speed of 100 \~ 120 ml/h. If enteral nutrition could not meet a patient's caloric requirements, PN supplement was started on the fourth day. The required calories and protein for each individual in the two groups was assumed to be achieved after three days of therapy. The PN group continued to receive parenteral nutrition.
Primary Outcome Measures
NameTimeMethod
all cause mortality28 days
Secondary Outcome Measures
NameTimeMethod
organ failure7 days
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