一项随机临床试验的协议,以评估不常规测量胃残留体积,以指导机械通风重症儿童的肠道养与常规测量 (GASTRIC-PICU)
Marzena Orzol1, Irene Chang1, Emma Laing1
1Clinical Trials Unit, Intensive Care National Audit and Research Centre (ICNARC), London, United Kingdom.
概括
在儿科重症监护中停止常规胃残留体积 (GRV) 测量可能会改善营养供应,而不会影响患者的结果. 本研究评估了这种方法在通风儿童中的临床和成本效益.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 临床营养学 临床营养学
- 卫生经济学 卫生经济学
背景情况:
- 肠道营养对重症儿童至关重要,但常规胃残留体积 (GRV) 测量经常会中断养.
- 高GRV测量通常会导致不必要的食停止,可能会损害营养摄入量.
研究的目的:
- 评估在接受肠道养的机械通风儿童中停止常规GRV测量的临床和成本效益.
- 将没有常规GRV测量的标准养方案与常规 (≥6小时) GRV测量的协议进行比较.
主要方法:
- 一个多中心的,随机的,非劣势的,开放标签的临床试验 (GASTRIC-PICU) 涉及英国和瑞士的23个PICU.
- 参与者包括接受通风的婴儿和儿童 (≥37周修正妊娠年龄至16岁) 接受肠道养.
- 主要临床结局是30天后的生存和无机械通风日的复合;另一个主要结局是72小时后实现的能量需求. 健康经济评估是嵌入式的.
主要成果:
- 该研究比较了没有常规GRV测量的标准养与常规GRV测量的标准养.
- 收集的数据包括基线人口统计,临床状态,每日营养摄入量以及30天和6个月的结果 (临床和经济).
- 主要临床结果被评估为非劣势性,并对营养供应优越性的辅主结果进行评估.
结论:
- GASTRIC-PICU试验将确定是否保留常规GRV测量在临床上是有效的和具有成本效益.
- 结果将为儿科重症监护中肠道养管理的最佳实践提供信息.
- 结果将通过同行评审的出版物,会议和社交媒体传播.
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