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During the prone position, there may be an increase in intragastric pressure. The investigators focus on a scientific question: Whether reducing enteral nutrition before the prone position will benefit patients with severe mechanically ventilated acute respiratory distress syndrome (ARDS).
The experimental group had the enteral nutrition dose reduced before the prone position, while the control group did not have the enteral nutrition dose reduced
During the prone position, there may be an increase in intragastric pressure. The investigators focus on a scientific question: Whether reducing enteral nutrition before the prone position will benefit patients with severe mechanically ventilated ARDS.
The experimental group had the enteral nutrition dose reduced before the prone position, while the control group did not have the enteral nutrition dose reduced
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Enteral nutrition reduction group | Experimental | Before the prone position, the gastric contents are aspirated with a syringe, and the dose of enteral nutrition reduction is determined based on the different amounts of gastric residue. If the residual volume in the stomach is less than 200ml, the enteral nutrition intake will be reduced by one third. Gastric residual volume 200-500ml: Reduce enteral nutrition by half. If the residual gastric volume is greater than 500ml: Stop enteral nutrition and consider post-pyloric feeding |
|
| Conventional feeding group | No Intervention | Do not reduce the feeding speed before the prone position and continue to feed at the original speed |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Enteral nutrition is reduced before the prone position | Procedure | Before the prone position, the gastric contents are aspirated with a syringe, and the dose of enteral nutrition reduction is determined based on the different amounts of gastric residue. If the residual volume in the stomach is less than 200ml, the enteral nutrition intake will be reduced by one third. Gastric residual volume 200-500ml: Reduce enteral nutrition by half. If the residual gastric volume is greater than 500ml: Stop enteral nutrition and consider post-pyloric feeding |
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of gastric retention during prone position | The incidence of gastric retention (with a single gastric residual volume > 200ml) during prone position. | Acute stage of critical illness (within 7 days of Intensive Care Unit (ICU)) |
| Measure | Description | Time Frame |
|---|---|---|
| The frequency of gastric retention during the prone position | The number of times of gastric retention (with a single gastric residual volume > 200ml) per unit time during prone position (times per day) | Acute stage of critical illness (within 7 days of ICU) |
| The incidence of diarrhea during ICU stay |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Youquan Wang, M.D. | Contact | +8615584299391 | wangyq20@mails.jlu.edu.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Hospital of Jilin University | Recruiting | Changchun | Jilin | 130021 | China |
Individual participant data (IPD) will be available upon reasonable request. Researchers interested in obtaining the data should contact the corresponding author with a clear statement of the purpose of data access. The corresponding author will evaluate the request and determine whether access can be granted to part of the de-identified dataset.
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| ID | Term |
|---|---|
| D008224 | Lymphoma, Follicular |
| ID | Term |
|---|---|
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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|
Having three or more loose or liquid stools per day, with a stool weight greater than 200-250g/d (or more than 250ml/d) |
| Acute stage of critical illness (within 7 days of ICU) |
| EN interruption rate | High gastric residual volume (single dose > 500ml) or serious gastrointestinal adverse events lead to the need to suspend EN administration | Acute stage of critical illness (within 7 days of ICU) |
| The incidence of Ventilator-associated pneumonia (VAP) among the participants | Pulmonary infectious inflammation that occurs 48 hours after the end of ventilator treatment is a type of hospital-acquired pneumonia | During the length of stay in the ICU (from day 1 to a maximum of 28 days) |
| Nutrition compliance rate | Whether the patient reached 80% of the nutritional (calories: 25kcal/kg/day and protein :1.3g/kcal) target on the 7th day of hospitalization in the ICU | The seventh day in the ICU |
| Gastric antral cross-sectional area (ACSA) measured by ultrasound after the end of prone positioning | The ultrasound cross-sectional area of the antrum of the stomach after adjusting to the normal position at the end of the prone position | After each prone position during the ICU stay |
| Length of stay in the ICU | The number of days spent in the ICU | During the length of stay in the ICU (from day 1 to a maximum of 180 days) |
| ICU mortality | Whether there was death during the ICU stay | During the length of stay in the ICU (from day 1 to a maximum of 180 days) |
| 28-day mortality | Whether the patient died on the 28th day after being admitted to the ICU | Day 28 after being admitted to the ICU |
| 90-day mortality | Whether the patient died on the 90th and 180th days after being admitted to the ICU | The 90th day after being admitted to the ICU |
| 180-day mortality | Whether the patient died on the 180th day after being admitted to the ICU | Day 180 after being admitted to the ICU |
| The incidence of gastric retention during ICU stay | The incidence of gastric retention within 7 days of ICU hospitalization (The single gastric residual volume is greater than 200ml) | Within 1 to 7 days of hospitalization in the ICU |
| D008232 |
| Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |