Condition: Respiratory Insufficiency · Fasting · Dysphagia · Sponsor: University Hospital, Tours
Fasting in intensive care is mainly studied in mechanically ventilated patients or those in the weaning phase. Recent research challenge the common assumption of fasting and suggests that continuing enteral nutrition before extubation may be beneficial. Fasting is also practiced before procedures (e.g., tracheostomy, endoscopy) or surgeries, based on anesthetic guidelines. Yet, no data address fasting in non-intubated ICU patients with acute respiratory failure, despite frequent caloric deficits and inadequate nutritional intake. Aspiration risk often justifies fasting, but studies indicate that swallowing reflexes remain intact in patients receiving high-flow nasal oxygen or non-invasive ventilation. Moreover, although intubation carries a 2-5.9% aspiration risk, rapid sequence induction mitigates this, questioning the necessity of preventive fasting. Despite its prevalence, this practice lacks scientific validation and guideline support. Patient discomfort is also significant. Hunger and thirst are major sources of distress, and evidence from anesthesiology suggests that allowing fluid intake pre-anesthesia reduces discomfort. Extrapolating these findings to ICU patients could improve well-being. In conclusion, fasting in ICU patients may contribute to discomfort, dehydration, and malnutrition, while its protective benefits remain uncertain. We hypothesize that maintaining oral intake does not increase the risk of intubation or aspiration-related complications.
This description comes directly from the study's public registry record.
Piotr SZYCHOWIAK, MD · 2.38.22.95.58 · piotr.szychowiak@gmail.com
Always discuss trial participation with your own doctor first.
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| Intensive care, Hospital, Bourges | Bourges, France | Recruiting |
| Intensive care, Hospital, Colombes | Colombes, France | Recruiting |
| Intensive care, Hospital, Dreux | Dreux, France | Recruiting |
| Intensive care, Hospital, La Roche sur Yon | La Roche-sur-Yon, France | Recruiting |
| Intensive care, Hospital, Le MANS | Le Mans, France | Recruiting |
| Intensive care, Hospital, Lille | Lille, France | Recruiting |
| Intensive care, Hospital, Morlaix | Morlaix, France | Recruiting |
| Intensive care, Hospital, Nantes | Nantes, France | Recruiting |
| Intensive care, University Hospital, Orléans | Orléans, France | Recruiting |
| Intensive care, Hospital, poitiers | Poitiers, France | Recruiting |
| Intensive care, Hospital, Saint Brieuc | Saint-Brieuc, France | Recruiting |
+ 2 more locations — full list on the registry record.
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Source record: clinicaltrials.gov/study/NCT06510972