Effectiveness of enteral feeding protocol on clinical outcomes in critically ill patients: a study protocol for before-and-after design.
BACKGROUND
Enteral feed is an important component of nutritional therapy in critically ill patients and underfeeding has been associated with adverse outcomes. The article developed an enteral feeding protocol and planed a before-and-after comparative trial to explore whether implementation of enteral feeding protocol was able to improve clinical outcomes.


METHODS
The study will be conducted in intensive care units (ICUs) of ten tertiary care academic centers. Critically ill patients expected to stay in ICU for over 3 days and require enteral nutrition (EN) were potentially eligible. This is a before-and-after study comprising three phases: The first phase is the period without enteral feeding protocol; the second phase involves four-week training program, and the last phase is to perform the protocol in participating centers. We plan to enroll a total of 350 patients to provide an 80% power and 0.05 error rate to detect a 15% reduction of mortality. The primary outcome is 28-day mortality.


BACKGROUND
Ethical approval to conduct the research has been obtained from all participating centers. Additionally, the results will be published in peer-reviewed journal.


BACKGROUND
The study was registered at International Standard Registered Clinical/soCial sTudy Number (ISRCTN) registry (ISRCTN10583582).
Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, China ;
Zhongheng
Z
Zhang
Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou 310000, China ;
Qian
Q
Li
Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou 310000, China ;
Lingzhi
L
Jiang
Department of Critical Care Medicine, Huzhou Central Hospital, Hangzhou 310000, China ;
Bo
B
Xie
Department of Critical Care Medicine, Huzhou Central Hospital, Hangzhou 310000, China ;
Xiaowei
X
Ji
Department of Critical Care Medicine, Huzhou Central Hospital, Hangzhou 310000, China ;
Jiahong
J
Lu
Department of Critical Care Medicine, Zhejiang Provincial Hospital of TCM, Hangzhou 310000, China ;
Ronglin
R
Jiang
Department of Critical Care Medicine, Zhejiang Provincial Hospital of TCM, Hangzhou 310000, China ;
Shu
S
Lei
Department of Critical Care Medicine, Zhejiang Provincial Hospital of TCM, Hangzhou 310000, China ;
Shihao
S
Mao
Department of Critical Care Medicine, Shaoxing People's Hospital, Shaoxing 312000, China ;
Lijun
L
Ying
Department of Critical Care Medicine, Shaoxing People's Hospital, Shaoxing 312000, China ;
Di
D
Lu
Department of Critical Care Medicine, Yiwu Central Hospital, Yiwu 322000, China ;
Xiaoshui
X
Si
Department of Critical Care Medicine, Yiwu Central Hospital, Yiwu 322000, China ;
Jianxin
J
He
Department of Critical Care Medicine, Yiwu Central Hospital, Yiwu 322000, China ;
Mingxia
M
Ji
Department of Critical Care Medicine, Ningbo First Hospital, Ningbo 315000, China ;
Jianhua
J
Zhu
Department of Critical Care Medicine, Ningbo First Hospital, Ningbo 315000, China ;
Guodong
G
Chen
Department of Critical Care Medicine, Ningbo First Hospital, Ningbo 315000, China ;
Yadi
Y
Shao
Department of Critical Care Medicine, Taizhou Hospital, Taizhou 318000, China ;
Yinghe
Y
Xu
Department of Critical Care Medicine, Taizhou Hospital, Taizhou 318000, China ;
Ronghai
R
Lin
Department of Critical Care Medicine, Taizhou Hospital, Taizhou 318000, China ;
Chao
C
Zhang
Department of Critical Care Medicine, Quzhou People's Hospital, Quzhou 324000, China ;
Weiwen
W
Zhang
Department of Critical Care Medicine, Quzhou People's Hospital, Quzhou 324000, China ;
Jian
J
Luo
Department of Critical Care Medicine, Lishui People's Hospital, Lishui 323000, China.
Tianzheng
T
Lou
Department of Critical Care Medicine, Lishui People's Hospital, Lishui 323000, China.
Xuwei
X
He
Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, China ;
Kun
K
Chen
Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou 310000, China ;
Renhua
R
Sun
Enteral feeding; intensive care unit (ICU); mortality; prospective; protocol
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