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The aim of this study is to evaluate the effects of using the GUSS-ICU Safe Nutrition Program after extubation in Intensive Care Unit patients. This randomized controlled trial will be conducted in the Anesthesia Intensive Care Unit of Bakırköy Dr. Sadi Konuk Training and Research Hospital. Eligible participants will be randomly assigned to either the control group (usual care/routine follow-up group) or the intervention group (GUSS-ICU patients). Patients undergoing GUSS-ICU assessment will continue the nutritional program, as directed by the scale, for four days. Data are recorded on the first and last day. The data will then be evaluated in conjunction with the control group data.
The aim of this study is to evaluate the effects of using the GUSS-ICU Safe Nutrition Program after extubation in intensive care patients. This randomized controlled trial will be conducted in the Anesthesia Intensive Care Unit of Bakırköy Dr. Sadi Konuk Training and Research Hospital. Patients who meet the criteria will be randomized into either an intervention group or a control group. Patients in the control group will receive routine post-extubation care, follow-up, and a nutrition plan. On day 1, baseline data will be collected using the m-NUTRIC score, APACHE-II, SOFA, Charlson Comorbidity Index (CCI), Scored Patient-Generated Subjective Global Assessment (PG-SGA), and a patient data form. Routine follow-up and nutrition plans will be continued. At the end of day 4, the m-NUTRIC score, APACHE-II, SOFA, Charlson Comorbidity Index (CCI), Scored Patient-Generated Subjective Global Assessment (PG-SGA), and a patient data form will be completed. Patients in the intervention group undergo a GUSS-ICU assessment within the first 4 hours after extubation. Nutrition planning is based on the assessment scores. On day 1, baseline data includes the m-NUTRIC score, APACHE-II, SOFA, Charlson Comorbidity Index (CCI), Scored Patient-Generated Subjective Global Assessment (PG-SGA), and a patient data form. Nutritional monitoring and follow-up are continued for 4 days. At the end of day 4, the m-NUTRIC score, APACHE-II, SOFA, Charlson Comorbidity Index (CCI), Scored Patient-Generated Subjective Global Assessment (PG-SGA), and a patient data form are completed. The data will then be evaluated in conjunction with the control group data.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GUSS-ICU Applied Group | Experimental | The GUSS-ICU Scale, which is used for the transition to feeding of extubated patients, will be applied to the randomly selected intervention group included in the study, and feeding will be planned and continued for 4 days according to the score achieved. |
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| Routine Follow-up Group | No Intervention | Routine care and follow-up will be applied to the randomly selected control group for 4 days after extubation. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nutrion plan based on GUSS-ICU scale | Other | To ensure a rapid and accurate transition to post-extubation nutrition, patients will be assessed using the GUSS-ICU scale at 4 hours after extubation. A nutrition plan will be created based on the patient's GUSS-ICU score and will be maintained for 4 days. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in malnutrition risk scores and findings in intensive care patients who received a GUSS-ICU Safe Nutrition Program after extubation | Changes in malnutrition risk scores and findings in intensive care patients who received the GUSS-ICU Safe Nutrition Program after extubation will be evaluated with the PG-SGA. | On the 1st and 4th days after extubation |
| Changes in dehydration findings in intensive care patients who received a GUSS-ICU Safe Nutrition Program after extubation | Dehydration findings in intensive care patients who are applied GUSS-ICU Safe Nutrition Program after extubation will be evaluated with PG-SGA and patient data form. | On the 1st and 4th days after extubation |
| Change in the incidence of aspiration pneumonia in intensive care patients receiving a GUSS-ICU safe nutrition program after extubation | The data in the patient follow-up form will be evaluated with the clinician's supervision. | On the 1st and 4th days after extubation |
| Change in the frequency of GI symptoms in intensive care patients who received a post-extubation GUSS-ICU safe nutrition program | Changes in the frequency of GI symptoms in intensive care patients who received a GUSS-ICU Safe Nutrition Program after extubation will be evaluated with PG-SGA and Patient Data Form. | On the 1st and 4th days after extubation |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Modified Nutrition Risk in the Critically Ill (m-NUTRIC) score | It will be assessed with the Modified Nutrition Risk in the Critically Ill (m-NUTRIC) score. | On the 1st and 4th days after extubation |
| Change in APACHE II score |
| Measure | Description | Time Frame |
|---|---|---|
| Change in the number of days from tube feeding to oral feeding | Change in the number of days from tube feeding to oral feeding | From the first to the last day of follow-up after extubation |
| Change in oral intake (calorie) |
Inclusion Criteria:
Age 18 and over Patients expected to remain intubated for more than 24 hours. Patients who have been extubated for no more than 4 hours.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Merve TURKAY | Contact | +905313793706 | turkay_merve@hotmail.com | |
| Zeliha TÜLEK | Contact | +905327762993 | tulekz@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| Merve TURKAY | Istanbul Universitesi-Cerrahpasa | Principal Investigator |
| Zeliha TÜLEK | Istanbul Universitesi-Cerrahpasa | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bakırköy Dr. Sadi Konuk Training and Research Hospital | Recruiting | Istanbul | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37055724 | Background | Troll C, Trapl-Grundschober M, Teuschl Y, Cerrito A, Compte MG, Siegemund M. A bedside swallowing screen for the identification of post-extubation dysphagia on the intensive care unit - validation of the Gugging Swallowing Screen (GUSS)-ICU. BMC Anesthesiol. 2023 Apr 13;23(1):122. doi: 10.1186/s12871-023-02072-6. |
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| ID | Term |
|---|---|
| D003680 | Deglutition Disorders |
| ID | Term |
|---|---|
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D010608 | Pharyngeal Diseases |
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The effects on mortality will be evaluated with the APACHE II score.
| On the 1st and 4th days after extubation |
| Change in SOFA (Sequential Organ Failure Assessment) Score | SOFA (Sequential Organ Failure Assessment) Score will be evaluated to determine the effects on mortality. | On the 1st and 4th days after extubation |
| Change in Scored Patient-Generated Subjective Global Assessment (PG-SGA) score | Possible effects on nutrition will be evaluated using the Scored Patient-Generated Subjective Global Assessment (PG-SGA). | On the 1st and 4th days after extubation |
Change in oral intake (calorie)
| From the first to the last day of follow-up after extubation |
| Istanbul Universitesi-Cerrahpasa | Recruiting | Istanbul | Turkey (Türkiye) |
| D010038 | Otorhinolaryngologic Diseases |