Intermittent versus Continuous Feeding on the Intensive Care Unit v3

• Research type

  Research Study

• Full title

  A Phase 2 Pilot Physiological Randomised Clinical Trial to Investigate the Effect of Intermittent versus Continuous Enteral Nutrition on Muscle Wasting in Critical Illness

• IRAS ID

  160281

• Contact name

  Angela McNelly

• Contact email

  angela.mcnelly.10@ucl.ac.uk

• Sponsor organisation

  Guy's & St Thomas' NHS Foundation Trust

• Duration of Study in the UK

  1 years, 11 months, 29 days

• Research summary

  Longstanding muscle weakness is a common consequence of admission to an Intensive Care Unit (ICU). It impairs survivors’ physical ability, and impacts psychologically, emotionally and financially on the patient, their relatives and carers. No effective treatments exist which limit this wasting. We suspect that a change in the way patients are fed might offer such protection.
  In health, muscle mass is maintained by a balance between muscle protein production and its breakdown: critical illness shifts this towards excess breakdown. Current practice worldwide is to feed critically ill patients continuously (usually via a tube through the nose into the stomach). This may, in fact, increase muscle protein breakdown, since continuous high blood levels of amino acids (the building blocks of protein) prevent muscle build-up and cause its breakdown.
  Ultrasound scans reliably track changes in the size of thigh muscles during ICU stay. We will use them to see whether 10-day muscle loss is less with intermittent (4-hourly) feeding (like 'meals') than with standard continuous feeding, in patients admitted to ICU in one teaching and one community hospital. We will see whether this also translates into better results for the patients, decreasing their need for support from breathing machines, and their time in ICU and hospital. We will also see whether they have higher activity levels and improvements in their daily lives a year after ICU discharge, as well as reductions in primary healthcare usage and costs. Using this study as a backbone, we will analyse blood and urine samples, to further explore any changes in muscle bulk during critical illness.
  
  

• REC name

  London - Queen Square Research Ethics Committee

• REC reference

  14/LO/1792

• Date of REC Opinion

  12 Nov 2014

• REC opinion

  Further Information Favourable Opinion