Energy Expenditure in ACLF (EEACLF)
Research type
Research Study
Full title
Energy Expenditure and Substrate Utilisation in Acute on Chronic Liver Failure.
IRAS ID
294224
Contact name
William Bernal
Contact email
Sponsor organisation
KING'S COLLEGE HOSPITAL NHS FOUNDATION TRUST, LONDON
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Acute on Chronic Liver Failure (ACLF) is a severe critical illness that may develop in people who have chronic liver disease (CLD) from Cirrhosis. Following a triggering event such as an infection or intestinal bleed, they rapidly develop multiple organ failure (MOF) requiring treatment in an intensive care unit (ICU). ACLF has a short-term mortality that may exceed 50% and there is urgent need for more effective treatment.
An important part of this treatment is providing nutritional support. Critical illness is associated with high energy needs and rapid loss of body protein that affects muscle and immune function. People with ACLF are at particular risk as they are often already malnourished when they become ill, and the complex metabolic disturbances seen in CLD and over the course of ACLF make effective feeding difficult. There is limited information to inform decisions on what nutrition should be provided, and it is known that in the equations currently used to predict energy and feeding needs in critical illness are very inaccurate; either under- or over-supply can result in increased complications and mortality.
We want to address these important knowledge gaps. The study will be conducted in ICUs and wards at Kings College Hospital by researchers experienced in working with people with CLD and who are critically ill and lacking capacity. Using non-invasive technology that analyses the gases in people’s breath ('Indirect Calorimetry') and through blood testing that assesses metabolic activity, we will study energy expenditure and metabolism of people with ACLF over the course of illness. By comparing their results with those from people with other critical illnesses and with CLD without ACLF we will get a better understanding of the complex metabolic changes in ACLF, and how to best predict feeding requirements for most effective nutritional support.REC name
North East - Newcastle & North Tyneside 1 Research Ethics Committee
REC reference
22/NE/0007
Date of REC Opinion
14 Jan 2022
REC opinion
Favourable Opinion