ClinicalTrials.gg
CompletedNCT03480555ReplenishUpdated Jan 5, 2021

Replacing Protein Via Enteral Nutrition in a Stepwise Approach in Critically Ill Patients

An interventional study of Replenish Protein and Standard protein in Critical Illness, ARDS and Septic Shock, sponsored by King Abdullah International Medical Research Center. Completed at 2 sites in Saudi Arabia. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-01-05.

Primary conditionShock, SepticRegistry: Critical IllnessReclassifiedWhy we changed it
Registry
Critical Illness — the first condition term the registry derived for this study.
ClinicalTrials.gg
Shock, Septic
Why
  1. Critical Illness is a broad heading, used only when no more specific condition is named.
  2. The study's listed conditions name Shock, Septic.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by King Abdullah International Medical Research Center · Not applicable, Interventional, and Other

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

In this study, we will explore the feasibility of a randomized controlled trial that will compare high protein dose from ICU day 6 to 14 with moderate protein intake.

Read the detailed description

Patients will be recruited on day 1-2 of ICU admission. On day 5, patients will be randomized into one of the two intervention arms;

Replenish Protein group:

Patients randomized to this group will receive 2 g of protein/kg/day (acceptable range 1.8 - 2.2 g of protein/kg/day) for day 6-14.

Standard Protein group:

Patients randomized to this group will receive protein at 0.8 - 1.0 g of protein/kg/day for day 6-14

02

Conditions studied

  • Critical Illness
  • ARDS
  • Septic Shock
  • Multiple Trauma
  • Seizure Disorder
  • Hemorrhagic Shock

Keywords

  • Enteral nutrition, Intensive Care Units, caloric restriction, insulin, mortality, protein catabolism
03

In context

Shock, Septic Reclassified

1,078 studies on the registry are indexed under Shock, Septic; 232 are open to participants now.

This study's enrollment of 40 is below the median of 79 across 636 interventional studies indexed under Shock, Septic.

Browse Shock, Septic studies →

Lead sponsor

King Abdullah International Medical Research Center is the lead sponsor of 46 studies on the registry; 6 are open to participants now.

Compared within Shock, Septic, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Critical Illness. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age ≥ 18 years
  2. Mechanically ventilated
  3. Receiving enteral feeding via nasogastric/orogastric or duodenal or PEG or jejunostomy tubes and
  4. Expected to stay ≥ 1 week in the ICU

Exclusion criteria

Exclusion criteria

  1. Lack of commitment to ongoing life support, which includes;

    • Terminal Illness ( or irreversible condition with 6 month mortality > 50%)
    • DNR order in the first 48 hours and brain death within 48 hours of admission) (Don't include the presence of a "Do Not Resuscitate" order alone, if there is a commitment to ongoing life support).
  2. Patients not fed within 48 hours of admission
  3. Patients on total parenteral nutrition (TPN)
  4. Patients being fed orally
  5. Chronic renal failure
  6. Chronic liver disease
  7. Renal replacement therapy
  8. Pregnancy.
  9. Kidney transplant
  10. Post-liver transplant.
  11. Post cardiac arrest.
  12. Burn patients.
  13. Prisoners

Screened patients will be screened again for eligibility at day 5, should be mechanically ventilated and expected to stay ≥ 3 days in the ICU. At this point, patients will be excluded if they meet the following;

  1. New onset renal replacement therapy.
  2. Acute Kidney Injury (serum creatinine > 3 times the preacute level or serum creatinine >350mmol/L with a recent increase of >44 mmols/L)
  3. Significant liver impairment
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
40 participants (actual)

Study arms

  • Active comparator
    Replenish Protein group

    Subjects randomized to this group will receive 2 g of protein/kg/day (acceptable range as 1.8 - 2.2 g of protein/kg/day) for day 6-14.

    Dietary Supplement: Replenish Protein

  • Other
    Standard Protein group

    Subjects randomized to this group will receive 0.8 - 1 g of protein/kg/day for day 6-14

    Dietary Supplement: Standard protein

Interventions

  • Dietary supplementReplenish Protein

    Subjects randomized to this group will receive 2 g of protein/kg/day (acceptable range as 1.8 - 2.2 g of protein/kg/day) for day 6-14.

    Also known as: Intervention group

  • Dietary supplementStandard protein

    Subjects randomized to this group will receive 0.8 - 1 g of protein/kg/day for day 6-14

    Also known as: Control group

06

What researchers measure

Primary outcomes

  1. Recruitment

    Recruitment log

    Time frame: 6 months

  2. Retention rate

    withdrawals

    Time frame: 14 days

  3. Achieved protein intake

    Feeding data

    Time frame: 14 days

07

Study locations

2 sites
  • King Abdulaziz Medical city
    Jeddah, 21423, Saudi Arabia
  • King Abdulaziz Medical city
    Riyadh, 11426, Saudi Arabia
08

References and documents

Publications

  • McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA, Gervasio JM, Sacks GS, Roberts PR, Compher C; Society of Critical Care Medicine; American Society for Parenteral and Enteral Nutrition. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016 Feb;40(2):159-211. doi: 10.1177/0148607115621863. No abstract available. Erratum In: JPEN J Parenter Enteral Nutr. 2016 Nov;40(8):1200. doi: 10.1177/0148607116670155. PubMed 26773077 ↗
  • Arabi YM, Aldawood AS, Solaiman O. Permissive Underfeeding or Standard Enteral Feeding in Critical Illness. N Engl J Med. 2015 Sep 17;373(12):1175-6. doi: 10.1056/NEJMc1509259. No abstract available. PubMed 26376142 ↗
  • Arabi YM, Casaer MP, Chapman M, Heyland DK, Ichai C, Marik PE, Martindale RG, McClave SA, Preiser JC, Reignier J, Rice TW, Van den Berghe G, van Zanten ARH, Weijs PJM. The intensive care medicine research agenda in nutrition and metabolism. Intensive Care Med. 2017 Sep;43(9):1239-1256. doi: 10.1007/s00134-017-4711-6. Epub 2017 Apr 3. PubMed 28374096 ↗
  • Arabi YM, Al-Dorzi HM, Tamim H, Sadat M, Al-Hameed F, AlGhamdi A, Al Mekhlafi GA, Rasool G, Afesh L, Sakkijha MH, Alamrey NK, Malebari R, Alhutail RH, Al-Dawood A; Saudi Critical Care Trials Group. Replacing protein via enteral nutrition in a stepwise approach in critically ill patients: A pilot randomized controlled trial (REPLENISH pilot trial). Clin Nutr ESPEN. 2021 Aug;44:166-172. doi: 10.1016/j.clnesp.2021.05.008. Epub 2021 Jun 2. PubMed 34330462 ↗

Individual participant data

Plan to share: No — Data will be shared with the other participating sites after the completion of the main study and upon the descretion of the study Principle investigator only

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from May 2018 to primary completion in May 2019, 11 months.

Of 164 non-industry interventional studies with no phase under Shock, Septic, half reached primary completion within 25 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 41. This study's 11 months is below that.

Counting every sponsor, half of 172 studies reached it within 25 months; a quarter within 12 and three quarters within 42.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 22, 2018
First posted
Mar 29, 2018
StartActual
May 16, 2018
Primary completionActual
May 10, 2019
CompletionActual
Sep 10, 2019
Last update
Jan 5, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jan 5, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03480555
Lead sponsor
King Abdullah International Medical Research Center
Responsible party
Sponsor
First posted
Mar 29, 2018
Start date
May 16, 2018
Primary completion
May 10, 2019
Completion
Sep 10, 2019
Last update
Jan 5, 2021

Study contacts

Yaseen M Arabi, MD
principal investigator · King Abdulaziz Medical City-Ministry of National Guard

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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