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Study in ICU Patients Regarding Protein Intake and CT-derived Body Composition

Completed
Conditions
Muscular Atrophy
Interventions
Other: Computed tomography scan made for clinical reasons
Dietary Supplement: Nutrition as per hospital protocol
Registration Number
NCT02817646
Lead Sponsor
Amsterdam UMC, location VUmc
Brief Summary

The purpose of this study is to determine whether protein intake during the first days of intensive care admission, in relation to body composition at intensive care admission as assessed on computed tomography scans made during routine care, is are related to clinical outcome in critically ill patients.

Detailed Description

Optimal protein and energy intake have been shown to be relevant for reducing mortality in prospective observational studies in mechanically ventilated patients admitted to the intensive care unit. However, nutritional status (protein mass, muscle mass) of patients at admission and possible consequences for clinical outcome are largely unknown. Computerized tomography scans can be used to assess muscle mass as a proxy for body protein mass.

The investigators are especially interested in the effect of protein intake on clinical outcome in intensive care patients with different body protein mass at admission. This is relevant for appropriate formulation of clinical (protein) nutrition in this patient group. Therefore, the relationship between protein intake and patient outcome is evaluated in intensive care patients with low muscle and normal muscle area, using muscle area from computed tomography scans as a proxy of body protein mass.

Additionally, data from computed tomography scans regarding muscle quality and muscle- and fat quantity are used to evaluate the prognostic value of body composition at intensive care admission. Finally, abdominal computed tomography scans are compared with thoracic computed tomography scans.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
800
Inclusion Criteria
  • Abdominal computed tomography scan made 1 day before up to 4 days after admission to the intensive care unit
  • Length of intensive care stay of at least 4 days
  • Mechanical ventilation during intensive care stay
Exclusion Criteria
  • Computed tomography scan not eligible for analysis
  • Missing data

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Intensive care patientsNutrition as per hospital protocolPatients admitted to the intensive care unit for 4 days or more with a computed tomography scan made for clinical reasons early during intensive care stay and who receive enteral and/or parenteral nutrition as per hospital protocol
Intensive care patientsComputed tomography scan made for clinical reasonsPatients admitted to the intensive care unit for 4 days or more with a computed tomography scan made for clinical reasons early during intensive care stay and who receive enteral and/or parenteral nutrition as per hospital protocol
Primary Outcome Measures
NameTimeMethod
All-cause mortalityFrom admission to the intensive care unit untill discharge from the hospital, an average of one month
Secondary Outcome Measures
NameTimeMethod
Percentage of patients discharged to homeAfter discharge from the hospital, on average after one month
Length of hospital stay (days)The total duration of admission to the hospital, an average of one month
Length of intensive care unit stayThe total duration of admission to the intensive care unit, an average of two weeks
Length of ventilationThe total duration of mechanical ventilation during intensive care unit stay, an average of 10 days
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