Actively Recruiting

Phase Not Applicable
Age: 18Years - 65Years
All Genders
ID06825377

Comparing the Effects of High-protein Nutritional Support with Standard Protein Nutritional Support Using Whey Protein Supplements on Outcomes of Critically Ill Patients At Risk for Refeeding Syndrome

Led by Shahid Beheshti University · Updated on 2025-02-14

150

Participants Needed

1

Research Sites

8 weeks

Total Duration

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AI-Summary

What this Trial Is About

This clinical trial is focused on critically ill patients who are at risk for refeeding syndrome (RS) and are receiving supportive nutrition in an ICU setting. Researchers aim to find the best protein administration method to improve nutritional and clinical outcomes, reduce complications, and lower mortality. The study tests the hypothesis that a higher protein intake may decrease the occurrence of refeeding syndrome and improve overall patient outcomes, including shorter ICU and hospital stays. Participants are randomly assigned to either a high-protein group or a standard-protein group. Both groups receive nutritional support starting with low calorie intake that gradually increases. The high-protein group targets 2 grams of protein per kilogram of body weight per day, while the standard-protein group targets 1.3 grams per kilogram per day. Protein is gradually introduced, with whey protein powder added if needed, and the intervention lasts for 14 days with a minimum of 5 days. All patients receive daily thiamine and multivitamin-mineral supplements during the study. During the trial, patients are closely monitored with daily laboratory tests for key blood levels and organ function using scoring systems like SOFA. Researchers track the number of patients who develop refeeding syndrome within the first week, as well as secondary outcomes like infections, organ failure, length of ICU and hospital stays, and mortality up to 45 days after admission. The study involves regular assessments and careful monitoring to understand the effects of protein intake on these critically ill patients.

CONDITIONS

Brief Title

Comparing High-protein Vs. Standard Protein Nutritional Support in Critically Ill Patients At Risk for Refeeding Syndrome

Who Can Participate

Age: 18Years - 65Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Willingness to cooperate and sign informed consent by the patient or legal guardian
  • Age 18 years or older and under 65 years
  • Not pregnant or breastfeeding
  • Serum creatinine of at least 1.1 mg/dl for women and 1.2 mg/dl for men
  • No organ failure at the time of enrollment
  • Start of intervention within 48 hours of ICU admission
  • No history of metastatic cancer or end-stage disease
  • No absolute contraindications to enteral nutrition such as persistent ileus or gastrointestinal ischemia
  • No active infections, sepsis, severe sepsis, or septic shock
  • No intolerance to the whey protein supplement
  • Not participating in other clinical trials at the same time
  • No clinical conditions requiring different protein needs such as burns, sepsis, cirrhosis, or chronic kidney disease
  • No diabetes with severe complications like ketoacidosis or hyperosmolar coma
Not Eligible

You will not qualify if you...

  • Unwillingness to continue participation during the study
  • Discharge or death within 5 days of starting the intervention
  • Occurrence of side effects during the study

AI-Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 screening and enrollment visit (in-person)

Treatment

Duration - Minimum of 5 days, up to 14 days

Participants receive nutritional support with either high-protein or standard-protein intake using whey protein supplements as needed. Protein intake is gradually introduced starting at a low level, with monitoring of serum creatinine to adjust supplementation. All participants receive thiamine and multivitamin-mineral supplements daily before starting nutrition. Calorie intake begins low and increases cautiously due to risk of refeeding syndrome.

Daily visits for monitoring during the treatment period

Follow-up

Duration - Up to 45 days after admission

Participants are monitored for clinical outcomes including refeeding syndrome, infections, organ failure, ICU and hospital length of stay, and mortality up to 45 days after admission.

Regular assessments during ICU and hospital stay up to 7 weeks; mortality monitored up to 45 days

Trial Site Locations

Total: 1 location

1

Ayatollah Taleghani Medical, Educational, and Therapeutic Center, Shahid Beheshti University of Medical Sciences

Tehran, Iran

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Research Team

Z

Zahra Vahdat Shariatpanahi Professor

How is the study designed?

Study Type

INTERVENTIONAL

Masking

QUADRUPLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

SUPPORTIVE_CARE

Number of Arms

2

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