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The Effect of Intermittent Oro-esophageal Tube Feeding on Severe Traumatic Brain Injury Patients With Tracheostomy

Not Applicable
Terminated
Conditions
Traumatic Brain Injury
Interventions
Behavioral: Rehabilitation therapy
Device: Intermittent Oro-esophageal Tube Feeding
Device: Nasogastric tube feeding
Registration Number
NCT06248970
Lead Sponsor
Zeng Changhao
Brief Summary

This was a multicenter randomized controlled study of 98 severe Traumatic Brain Injury patients with tracheostomy. Patients enrolled were divided randomly into the observation group with Intermittent Oro-esophageal Tube Feeding (n=50) or the control group with Nasogastric tube feeding (n=48) for enteral nutrition support, respectively. Nutritional status, complications, decannulation of tracheostomy tubes and level of consciousness on day 1 and day 28 were recorded and compared.

Detailed Description

The safe and effective nutrition support for severe traumatic brain injury patients with tracheostomy continues to be a challenge. Nasogastric tube feeding has been the mainstream choice in China but with the risk of complications. Intermittent Oro-esophageal Tube Feeding is an established modality of enteral nutrition support that can be used with routine treatment. This study reports the clinical outcomes of Intermittent Oro-esophageal Tube Feeding vs. nasogastric tube feeding, in patients receiving routine treatment. This was a multicenter randomized controlled study of 98 severe traumatic brain injury patients with tracheostomy. Patients enrolled were divided randomly into the observation group with Intermittent Oro-esophageal Tube Feeding (n=50) or the control group with Nasogastric tube feeding (n=48) for enteral nutrition support, respectively. Nutritional status, complications, decannulation of tracheostomy tubes and level of consciousness on day 1 and day 28 were recorded and compared.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
104
Inclusion Criteria
  • age ≥ 18 years, meeting the diagnosis of severe Traumatic Brain Injury;
  • score of Glasgow Coma Scale<8;
  • presence of no contraindication for enteral nutrition;
  • with stable vital signs and no severe liver or kidney dysfunction, metabolic disorders, cardiovascular diseases, or multiple complications;
  • informed consent form was obtained from the patient&#39;s family members, indicating their full understanding of the study and agreement to participate.
Exclusion Criteria
  • unable to cooperate in completing treatment and assessment due to personal reasons or other disorders;
  • complicated with other intracranial lesions, such as stroke;
  • with severe consciousness disorders caused by other diseases.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
the observation groupRehabilitation therapyBoth groups of patients were provided with routine treatments, including pharmacological treatment, rehabilitation therapy.Based on this, the patients in the observation group were given enteral nutrition support with Intermittent Oro-esophageal Tube Feeding (Medical Device No. 20010234, developed by the Swallowing Disorders Research Institute of Zhengzhou University).
the control groupRehabilitation therapyBoth groups of patients were provided with routine treatments, including pharmacological treatment, rehabilitation therapy. The patients in the control group were provided nutrition support with Nasogastric tube feeding , while the feeding process strictly followed the relevant guideline
the observation groupIntermittent Oro-esophageal Tube FeedingBoth groups of patients were provided with routine treatments, including pharmacological treatment, rehabilitation therapy.Based on this, the patients in the observation group were given enteral nutrition support with Intermittent Oro-esophageal Tube Feeding (Medical Device No. 20010234, developed by the Swallowing Disorders Research Institute of Zhengzhou University).
the control groupNasogastric tube feedingBoth groups of patients were provided with routine treatments, including pharmacological treatment, rehabilitation therapy. The patients in the control group were provided nutrition support with Nasogastric tube feeding , while the feeding process strictly followed the relevant guideline
Primary Outcome Measures
NameTimeMethod
Concentration of albuminday 1 and day 28

albumin was tested with blood routine test

Nutritional status-body mass indexday 1 and day 28

body mass index was tested with body weight and height. Combination was calculated as: body weight (kg) / height (m)\^2.

Concentration of hemoglobinday 1 and day 28

hemoglobin was tested with blood routine test

Concentration of prealbuminday 1 and day 28

prealbumin was tested with blood routine test

Secondary Outcome Measures
NameTimeMethod
Pulmonary Infectionsday 1 and day 28

During the treatment, the occurrence of complications was recorded for both groups(24). These complications included but were not limited to: 1) Pulmonary Infections: Monitoring for the development of respiratory infections such as pneumonia or bronchitis.

Diarrheaday 1 and day 28

Monitoring for loose or watery stools, which may indicate gastrointestinal disturbances or medication side effects.

Level of consciousnessday 1 and day 28

The Glasgow Coma Scale was used to assess the level of consciousness in patients. A score of 15 indicates normal consciousness, a score of 13-14 indicates mild consciousness impairment, a score of 9-12 indicates moderate consciousness impairment, and a score less than 8 indicates severe consciousness impairment.

Gastrointestinal Bleedingday 1 and day 28

Observing for any signs of bleeding within the digestive tract, which may manifest as blood in the stool or vomiting of blood.

Gastric Retentionday 1 and day 28

Evaluating whether there was delayed emptying of the stomach contents, leading to symptoms such as bloating, nausea, and vomiting.

Gastroesophageal Refluxday 1 and day 28

Gastroesophageal Reflux: Assessing the occurrence of reflux from the stomach into the esophagus, which can cause symptoms like heartburn and regurgitation.

Decannulation of tracheostomy tube-placement durationday 1 and day 28

The duration of tracheostomy tube retention and the outcomes of decannulation were recorded for two groups during the treatment. The criteria for tracheostomy tube removal were as follows: patients should exhibit no significant pulmonary complications (including the progressive decline in blood oxygen, carbon dioxide retention, pneumonia, etc.) during the capping trial, and should exhibit stable, regular breath and not require reintubation or tracheostomy within 72 hours after tube removal.

Trial Locations

Locations (1)

Zheng Da yi Yuan Hospital

🇨🇳

Zhenzhou, Hena, China

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