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Completed

NCT Number: NCT02796430

The ICALIC International Multicentric Study

This study will evaluate the ease of use of the new calorimeter (Q-NRG (COSMED, Italy)) in intensive care unit (ICU) patients compared to currently used calorimeters (i.e. Quark RMR 1.0(COSMED, Italy) or Deltatrac Metabolic Monitor (Datex, Finland)), as well as the stability and the feasibility of the measurements in various clinically relevant situations.

Time needed to prepare and start indirect calorimetry (IC) measurement will be compared as the measure of the ease of use of the calorimeter.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Vienna, Austria

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About this study

Background and Aims:

This study aims at evaluating the ease of use of the new calorimeter for the measurement of energy expenditure (EE) in intensive care unit (ICU) patients. EE in ICU patients is highly variable depending on the severity of the disease and treatments. Clinicians need to measure EE by indirect calorimetry (IC) to optimize nutritional support for the better clinical outcome. However, indirect calorimeters available on the market have insufficient accuracy for clinical and research use. Difficulties of handling and interpretation of results often limit IC in ICU patients. An accurate, easy-to-use calorimeter has been developed to meet these needs.

The Study Device:

The new calorimeter (Q-NRG, COSMED) is capable of IC measurements in mechanically ventilated patients without warm-up and limited calibration. The disposable in-line pneumotach flow meter and direct sampling of respiratory gas from the ventilator circuit enables the accurate measurement of oxygen consumption volume (VO2) and CO2 production volume (VCO2) to derive the energy expenditure. The software interface to manage the device and the collected data provides easy-to-use, user-friendly interface. Q-NRG does not bear the European Commission Conformity Mark (CE Mark), but has been approved by the Swiss authority for medical devices (Swissmedic) for use in this study. Q-NRG will be used in the way it is intended to be used as described in the instruction manual.

Currently used indirect calorimeters at each study center will be used as the comparator.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Mechanically ventilated adult ICU patients

Exclusion criteria

  • Fraction of inhaled oxygen (FIO2) > 70%
  • Positive end expiratory pressure (PEEP) >10cmH2O
  • Peak ventilatory pressure > 30cmH2O
  • Presence of air leaks from thoracic drain tube
  • Changes in vasoactive agent dose (>20%, <1 hr before and/or during IC)
  • Agitation or change in sedative dose (>20%, <1 hr before and/or during IC)
  • Change in body temperature (>0.5°C, <1 hr before and/or during IC)
  • Expected duration of ICU stay < 24 hours
  • Expected survival of the patient < 24 hours

Treatment and study plan

Time needed to start indirect calorimetry measurement

Other

Comparison of the time needed to start EE measurements by the new calorimeter and the currently used calorimeter, including the time needed for calibration, patient data input, connection to the ventilator circuit.

Indirect calorimetry measurement

Other

Comparison of EE measurements by the new calorimeter and the currently used calorimeter when using different mechanical ventilators, different ventilation modes, different patient conditions and severity

Primary outcomes

  1. Time needed to start indirect calorimetry (IC) measurement in Q-NRG compared to currently used calorimeters

    Time frame: immediately after the measurement

    Time from the start-up of the devices until the 1st recorded measurement will be measured and compared between Q-NRG and the currently used indirect calorimeters, including time needed for patient information input, warm-up and calibrations according to the instructions for the devices, and installation of the device components needed for the measurements on patients.

Secondary outcomes

  1. Comparison of energy expenditure(EE) from Q-NRG and currently used calorimeters

    Time frame: immediately after the measurement

    EE measured by Q-NRG and currently used calorimeters will be compared to identify the differences of the characteristics of the measurements according to the different types of calorimeters.

  2. Coefficient of variation (CV) of EE for different mechanical ventilators

    Time frame: immediately after the measurement

    CV of EE measured by Q-NRG when using different mechanical ventilators will be analyzed to evaluate the effects of the mechanical ventilators used during the indirect calorimetry measurement.

  3. CV of EE when using different ventilation modes

    Time frame: immediately after the measurement

    CV of EE measured by Q-NRG when using different mechanical ventilation modes will be analyzed to evaluate the effect of different mechanical ventilation modes used during the indirect calorimetry measurement.

  4. CV of EE in various ranges of oxygen and airway pressure support

    Time frame: immediately after the measurement

    CV of EE measured by the Q-NRG in different ranges of FiO2 will be analyzed to evaluate the difference in the stability of the measurements according to various FiO2 ranges.

  5. CV of EE when measured in different sedation/consciousness levels

    Time frame: immediately after the measurement

    CV of EE measured by the Q-NRG in different levels of sedation/consciouness will be analyzed to evaluate the difference in the stability of the measurements according to various sedation/consciousness levels.

  6. CV of EE when measured in different levels of patient severity

    Time frame: immediately after the measurement

    CV of EE measured by the Q-NRG in different levels of patient severity will be analyzed to evaluate the difference in the stability of the measurement according to various levels of severity.

Sponsors and collaborators

Lead sponsor

University Hospital, Geneva

Other

Collaborators

  • European Society for Clinical Nutrition and Metabolism
  • European Society of Intensive Care Medicine

Registry information

Official study title

Clinical Evaluation of the Ease of Use of a New Indirect Calorimeter for Energy Expenditure Measurement in ICU Patients: The ICALIC International Multicentric Study

Acronym: ICALIC

Important dates

Study start
2017
Primary completion
2019
Study completion
2019
First posted
Jun 10, 2016
Registry last updated
Jul 22, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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