Early parenteral nutrition vs. standard care in the critically ill patient: A level I randomised controlled trial.

危重患者的早期肠外营养与标准护理：I 级随机对照试验。

• 批准号: nhmrc : 402643
• 负责人: A/Pr Gordon Doig
• 金额: $ 123.51万
• 依托单位: The University of Sydney
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Project Grants
• 财政年份: 2006
• 资助国家: 澳大利亚
• 起止时间: 2006-01-01 至 2008-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/early-parenteral-nutrition-controlled-trial/77317
• 关键词: Early; parenteral; nutrition; vs.; standard

Nutritional support is accepted as a standard of care for the hospitalised patient however there is little agreement as to how it should be provided to the critically ill patient. Despite the fact that studies consistently link malnutrition to worse outcomes, the provision of nutritional support to the critically ill patient is highly variable. Although there is general agreement that it is best to feed critically ill patients via the gastrointestinal tract (stomach tube feeding), there is no general agreement as to when intravenous artificial nutrition should be begun if a patient cannot tolerate a feeding tube. A recent systematic review of all available clinical trials suggests that if a critically ill patient cannot be fed by a stomach tube for at least 24 hours, they may benefit from intravenous artificial nutrition. This is not what currently happens under standard care. The purpose of this multi-centre randomised controlled trial is to determine if early intravenous nutrition saves lives. Because of the cost, and possible risk of increased infections, a study of this type is required before early intravenous nutrition could become a routine therapy in Australia. Informed consent to participate in the study will be obtained from next of kin, or directly from the patient themselves. The study will be managed at the Royal North Shore Hospital, University of Sydney and will include 26 collaborating ANZ hospitals over 18 months.

营养支持已被接受为住院患者的护理标准，但对于如何向危重患者提供营养支持却缺乏一致意见。尽管研究一致认为营养不良与更糟糕的结果有关，但向危重患者提供营养支持的情况差异很大。尽管人们普遍认为最好通过胃肠道（胃管喂养）喂养危重患者，但对于如果患者不能耐受喂养管，何时开始静脉内人工营养尚无普遍共识。最近对所有可用临床试验的系统综述表明，如果危重患者至少24小时不能通过胃管进食，他们可能会受益于静脉内人工营养。这不是目前在标准护理下发生的情况。这项多中心随机对照试验的目的是确定早期静脉营养是否可以挽救生命。由于成本和可能增加感染的风险，在早期静脉营养成为澳大利亚的常规治疗之前，需要进行此类研究。将从近亲或直接从患者本人处获得参与研究的知情同意书。该研究将在悉尼大学皇家北岸医院进行管理，并将在18个月内包括26家合作的ANZ医院。