Effect of Different Feeding Modes in Intracerebral Hemorrhage: Improving Clinical Outcomes and Safety
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 118
- 试验地点
- 2
- 主要终点
- Number of cases of successful extubation
研究概览
简要总结
This was a multicenter, prospective, randomized controlled clinical trail involved tracheostomized patients with Intracerebral Hemorrhage.The goal of this clinical trial is to compare the clinical effect of Intermittent Oro-esophageal Tube Feeding vs Nasogastric Tube Feeding in Tracheostomized Patients with Intracerebral Hemorrhage. The main questions it aims to answer are:
Compared to Nasogastric Tube Feeding, can the Intermittent Oro-esophageal Tube Feeding better improve the nutritional status, extubation of tracheostomy tube, pulmonary infection, neurological deficit of Patients with Intracerebral Hemorrhage Compared to Nasogastric Tube Feeding, is the Intermittent Oro-esophageal Tube Feeding safer.
Participants will be divided into two groups randomly, with different nutritional support respectively.
详细描述
Safe and efficient enteral nutrition support for tracheostomized patients with intracerebral hemorrhage continues to be a challenge. Nasogastric tube feeding has been the mainstay in China but has a significant risk of adverse events. Intermittent oro-esophageal tube feeding is an established enteral nutrition mode that can be used to replace Nasogastric tube feeding. This study reports the clinical effect of Intermittent oro-esophageal tube feeding vs Nasogastric tube feeding in tracheostomized patients with intracerebral hemorrhage receiving basic medical treatment and comprehensive rehabilitation therapy.
However, in the field of intracerebral hemorrhage combined with tracheostomy, research on Intermittent oro-esophageal tube feeding is still relatively limited. Therefore, this study was carried out to explore the clinical effect of Intermittent oro-esophageal tube feeding vs. Nasogastric tube feeding in tracheostomized patients with intracerebral hemorrhage, mainly on nutritional status, extubation of tracheostomy tube, pulmonary infection, neurological deficit, and intervention-related adverse events.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •meeting the diagnostic criteria for Intracerebral Hemorrhage.
- •with placement of a tracheotomy tube.
- •requiring enteral nutrition support.
- •age over 18 years.
- •able to cooperate with treatment and questionnaire investigation.
排除标准
- •combined with tumors in the head, neck, esophagus, or gastrointestinal tract
- •an abnormal structure observed in the oral, pharyngeal, nasal regions or esophagus
- •with unstable vital signs or severe dysfunction of organs including heart, liver, lungs, or kidneys
- •with severe hemorrhagic disease or bleeding tendency;
- •with contraindications for enteral nutrition
- •with dysphagia caused by non-stroke-related reasons in the past
研究组 & 干预措施
The observation group
The patients were provided with 1) basic treatment including intracranial pressure reduction, anti-infection therapy, blood pressure and blood glucose control, and 2) comprehensive rehabilitation therapy including respiratory tract management, care for tracheotomy tube, comprehensive training for hemiplegic limbs, swallowing function training, pulmonary function training, and acupuncture.
For the observation group, the nasogastric tube was removed, and Intermittent oro-esophageal tube feeding was initiated for nutrition support within 4 hours after completing the admission assessment, following the standard Intermittent oro-esophageal tube feeding procedure.
干预措施: Intermittent Oro-esophageal Tube Feeding (Device)
The observation group
The patients were provided with 1) basic treatment including intracranial pressure reduction, anti-infection therapy, blood pressure and blood glucose control, and 2) comprehensive rehabilitation therapy including respiratory tract management, care for tracheotomy tube, comprehensive training for hemiplegic limbs, swallowing function training, pulmonary function training, and acupuncture.
For the observation group, the nasogastric tube was removed, and Intermittent oro-esophageal tube feeding was initiated for nutrition support within 4 hours after completing the admission assessment, following the standard Intermittent oro-esophageal tube feeding procedure.
干预措施: Basic treatment (Behavioral)
The control group
The patients were provided with 1) basic treatment including intracranial pressure reduction, anti-infection therapy, blood pressure and blood glucose control, and 2) comprehensive rehabilitation therapy including respiratory tract management, care for tracheotomy tube, comprehensive training for hemiplegic limbs, swallowing function training, pulmonary function training, and acupuncture.
Patients in the control group were provided with nutrition support by the indwelling nasogastric tube. The entire feeding process strictly followed the standardized procedure for nasogastric feeding.
干预措施: Basic treatment (Behavioral)
The control group
The patients were provided with 1) basic treatment including intracranial pressure reduction, anti-infection therapy, blood pressure and blood glucose control, and 2) comprehensive rehabilitation therapy including respiratory tract management, care for tracheotomy tube, comprehensive training for hemiplegic limbs, swallowing function training, pulmonary function training, and acupuncture.
Patients in the control group were provided with nutrition support by the indwelling nasogastric tube. The entire feeding process strictly followed the standardized procedure for nasogastric feeding.
干预措施: Nasogastric Tube Feeding (Device)
结局指标
主要结局
Number of cases of successful extubation
时间窗: day 30
The Number of cases of successful extubation for both groups was recorded and compared. The parameters or criteria for extubation were: 1) stable clinical condition and a respiratory rate of 12-22 breaths per minute. 2) strong coughing ability and minimal airway secretions. 3) after completing a trial of tracheostomy tube capping, patients showed no fever, dyspnea, or asthma within 72 hours. Additionally, their blood oxygen saturation remained above 95% and normal oxygen partial pressure was observed
次要结局
- Body mass index(day 1 and day 30)
- Serum albumin(day 1 and day 30)
- Hemoglobin(day 1 and day 30)
- Clinical Pulmonary Infection Score(day 1 and day 30)
- National Institutes of Health Stroke Scale(day 1 and day 30)
- Body mass index(day 1 and day 30)
- Serum albumin(day 1 and day 30)
- Hemoglobin(day 1 and day 30)
- Clinical Pulmonary Infection Score(day 1 and day 30)
研究者
Zeng Changhao
PI
People's Hospital of Zhengzhou University