Prevent Unnecessary Surgeon Holds of Ingestions for Tracheostomy (PUSH-IT)
State University of New York at Buffalo
Summary
The goal of this clinical trial is to evaluate nutrition administration in the time around the tracheostomy in patients with breathing tubes. The main questions it aims to answer are: * Will continuing nutrition up to the time of surgery (tracheostomy) decrease nutrition interruptions, thereby increasing food intake? * Does continuing nutrition up to the time of surgery increase instances of food going into the lungs or lung infections? Researchers will compare patients who have nutrition withheld 6 hours prior to surgery versus those who receive nutrition up until the time of surgery to see if there are differences in food intake, instances of food entering the lungs or lung infections.
Description
Malnutrition is a significant problem in the critically ill, however with busy operating room schedules, we often find that feeds are interrupted repetitively prior to elective surgery. These interruptions are practiced based on the American Society of Anesthesiologist guidelines for fasting intervals for elective surgery. These guidelines, however, were not created for critically ill, intubated patients. The theoretical concern for an increased risk of aspiration with continuation of enteral feeds up to the time of surgery persists without supporting evidence. Thus, there is a need for a univ…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * 18 years or older * admitted to the intensive care unit (ICU) * intubated and require tracheostomy Exclusion Criteria: * under 18 years * unable to obtain informed consent * deemed clinically brain dead within 7 days of enrollment * transitioned to comfort measures within 7 days of enrollment * Pregnant patients * Prisoners
Interventions
- OtherFeeds continued
Enteral feeds are continued up until time of surgery
- OtherFeeds held
Enteral feeds are stopped 6 or more hours before surgery
Locations (6)
- Nuvance Health - Danbury HospitalDanbury, Connecticut
- St. Mary's Medical CenterWest Palm Beach, Florida
- HCA Research Medical CenterKansas City, Missouri
- Erie County Medical Center (University at Buffalo)Buffalo, New York
- Lehigh Valley Health NetworkAllentown, Pennsylvania
- University of South Carolina Sch of Medicine /Prisma Health RichlandColumbia, South Carolina