一项评估创伤性颅脑损伤患者接受肠内营养时口服海藻糖对炎症因子、氧化应激、营养和临床状况影响的随机对照试验的研究方案。

Study protocol for a pilot randomised controlled trial evaluating the effectiveness of oral trehalose on inflammatory factors, oxidative stress, nutritional and clinical status in traumatic head injury patients receiving enteral nutrition.

机构信息

Department of Clinical Nutrition, School of Nutritional Science, Mashhad University of Medical Sciences, Mashhad, Iran.

Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

BMJ Open. 2022 Sep 19;12(9):e060605. doi: 10.1136/bmjopen-2021-060605.

Abstract

INTRODUCTION

In traumatic brain injury (TBI) patients, inflammatory processes and oxidative stress have been linked to the development of neurodegenerative diseases, disability, increased rate of muscle catabolism, malnutrition, hospital stay and mortality. Previous in vitro and in vivo studies have shown that trehalose can decrease inflammatory and oxidative factors. Therefore, the present study was designed to evaluate the effect of oral trehalose consumption on this marker in critically ill TBI patients at intensive care unit (ICU).

METHODS AND ANALYSIS

This study is a pilot randomised, prospective and double-blind clinical trial. The study sample size is of 20 (10 patients in each group) TBI patients aged 18-65 years at ICU. Randomisation is performed by permuted block randomisation method. The allocation ratio is 1:1. An intervention group will receive 30 g of trehalose instead, as a part of the carbohydrate of daily bolus enteral feeding and the control group will receive standard isocaloric hospital bolus enteral feeding for 12 days. The inflammatory factors (C reactive protein, interleukin 6) and oxidative stress markers (glutathione, malondialdehyde, superoxide dismutase, pro-oxidant-antioxidant balance, total antioxidant capacity) will be measured at the baseline, at the 6th day, and at the end of the study (12th day). Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II, Nutrition Risk in the Critically ill scores, 28-day mortality, anthropometric assessments and the clinical and nutritional status will be measured. Each patient's nutritional needs will be calculated individually. The statistical analysis would be based on the intention to treat.

ETHICS AND DISSEMINATION

The vice-chancellor of the research centre of Mashhad University of Medical Sciences is sponsoring this study. IR.MUMS.MEDICAL.REC.1400.113.

TRIAL REGISTRATION NUMBER

Iranian Registry of Clinical Trials (IRCT) Id: IRCT20210508051223N1, Registration date: 26 July 2021.

摘要

介绍

在创伤性脑损伤(TBI)患者中,炎症过程和氧化应激与神经退行性疾病的发展、残疾、肌肉分解代谢率增加、营养不良、住院时间和死亡率有关。先前的体外和体内研究表明,海藻糖可以降低炎症和氧化因子。因此,本研究旨在评估口服海藻糖消耗对重症监护病房(ICU)TBI 患者这一标志物的影响。

方法和分析

这是一项前瞻性、随机、双盲临床试验。研究样本量为 20 名(每组 10 名)年龄在 18-65 岁的 ICU 创伤性脑损伤患者。采用随机分组方法进行随机分组。分配比例为 1:1。干预组将接受 30 克海藻糖,作为每日推注肠内喂养碳水化合物的一部分,对照组将接受标准等热量医院推注肠内喂养 12 天。在基线、第 6 天和研究结束时(第 12 天),将测量炎症因子(C 反应蛋白、白细胞介素 6)和氧化应激标志物(谷胱甘肽、丙二醛、超氧化物歧化酶、促氧化剂-抗氧化剂平衡、总抗氧化能力)。序贯器官衰竭评估、急性生理学和慢性健康评估 II、危重症营养风险评分、28 天死亡率、人体测量评估以及临床和营养状况将进行测量。每位患者的营养需求将单独计算。统计分析将基于意向治疗。

伦理和传播

马什哈德医科大学研究中心副校长赞助了这项研究。IR.MUMS.MED.REC.1400.113。

试验注册号

伊朗临床试验注册中心(IRCT)Id:IRCT20210508051223N1,注册日期:2021 年 7 月 26 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bf9/9486343/cfac97529813/bmjopen-2021-060605f01.jpg

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