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重症成人强化营养治疗与常规治疗比较的方案总结和统计分析计划(INTENT):一项 II 期随机对照试验。

Protocol summary and statistical analysis plan for ntensive utrition herapy compard to usual care i criically ill adults (INTENT): a phase II randomised controlled trial.

机构信息

Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia

Nutrition Department, The Alfred Hospital, Melbourne, Victoria, Australia.

出版信息

BMJ Open. 2022 Mar 8;12(3):e050153. doi: 10.1136/bmjopen-2021-050153.

Abstract

INTRODUCTION

It is plausible that a longer duration of nutrition intervention may have a greater impact on clinical and patient-centred outcomes. The Intensive Nutrition care Therapy comparEd to usual care iN criTically ill adults (INTENT) trial will determine if a whole hospital nutrition intervention is feasible and will deliver more total energy compared with usual care in critically ill patients with at least one organ system failure.

METHODS AND ANALYSIS

This study is a prospective, multicentre, unblinded, parallel-group, phase II randomised controlled trial (RCT) conducted in 23 hospitals in Australia and New Zealand. Mechanically ventilated critically ill adult patients with at least one organ failure who have been in intensive care unit (ICU) for 72-120 hours and meet all of the inclusion and none of the exclusion criteria will be randomised to receive either intensive or usual nutrition care. INTENT started recruitment in October 2018 and a sample size of 240 participants is anticipated to be recruited in 2022. The study period is from randomisation to hospital discharge or study day 28, whichever occurs first, and the primary outcome is daily energy delivery from nutrition therapy. Secondary outcomes include daily energy and protein delivery during ICU and in the post-ICU period, duration of ventilation, ventilator-free days, total bloodstream infection rate and length of hospital stay. All other outcomes are considered tertiary and results will be analysed on an intention-to-treat basis.

ETHICS AND DISSEMINATION

Ethics approval has been received in Australia (Alfred Hospital Ethics Committee (HREC/18/Alfred/101) and Human Research Ethics Committee of the Northern Territory Department of Health (2019-3372)) and New Zealand (Northern A Health and Disability Ethics Committee (18/NTA/222). Results will be disseminated in an international peer-reviewed journal(s), at scientific meetings and via social media.

TRIAL REGISTRATION NUMBER

NCT03292237.

摘要

简介

营养干预持续时间较长可能对临床和以患者为中心的结局产生更大的影响,这是合理的。在重症成人中比较强化营养治疗与常规护理的密集营养护理治疗试验(INTENT)将确定整个医院营养干预是否可行,与常规护理相比,在至少一个器官系统衰竭的重症患者中是否能提供更多的总能量。

方法和分析

这是一项在澳大利亚和新西兰 23 家医院进行的前瞻性、多中心、非盲、平行组、二期随机对照试验(RCT)。至少有一个器官衰竭的机械通气重症成人患者,在重症监护病房(ICU)中已入住 72-120 小时,符合所有纳入标准且无任何排除标准,将被随机分配接受强化或常规营养护理。INTENT 于 2018 年 10 月开始招募,预计 2022 年将招募 240 名参与者。研究期间为随机分组至出院或研究日 28 天,以先发生者为准,主要结局是营养治疗的每日能量供应。次要结局包括 ICU 期间和 ICU 后期间的每日能量和蛋白质供应、通气持续时间、无呼吸机天数、总血流感染率和住院时间。所有其他结局均被视为三级,结果将基于意向治疗进行分析。

伦理和传播

澳大利亚(阿尔弗雷德医院伦理委员会(HREC/18/Alfred/101)和北领地卫生部人类研究伦理委员会(2019-3372))和新西兰(北部 A 卫生和残疾伦理委员会(18/NTA/222)已获得伦理批准。结果将在国际同行评议期刊、科学会议和社交媒体上发表。

试验注册

NCT03292237。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/040e/8905937/513df3c4c470/bmjopen-2021-050153f01.jpg

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