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CompletedNCT06164301Updated Mar 11, 2026

Value of Early Postoperative Peptide-based Formula in Critically Ill Obstetrics on Recovery Enhancement

An interventional study of Elemental amino-acids in Malnutrition in Pregnancy, Malnutrition; Protein and Postpartum Disorder, sponsored by Ain Shams University. Completed at 1 site in Egypt. Open to female participants aged 16 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-03-11.

Sponsored by Ain Shams University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
83
Allocation
Randomized
Ages
16 Years to 50 Years
Sex
Female
01

Study summary

This is the first trial to assess the early semi-elemental postoperative formula load to meet the protein requirements in the first and second day postoperative to enhance the recovery of critically ill parturient (value on ERAS of critically ill obstetrics)

Read the detailed description

The objective is to measure the effect of peptide-based semi-elemental formula in the early post-operative period on reaching protein adequacy as well as energy intakes, gut function, clinical outcomes, and the quality of recovery.

All candidates will be assessed thoroughly by history and examination, and informed consent will be taken. All patients will be admitted to the obstetrics ICU. where degree of severity of the condition will be assessed and the relevant protocol of treatment will be started. All patients will receive the treatment algorithm of critically ill as follow; Prophylactic anticoagulation (Enoxaparin 40 mg once daily) when appropriate after surgeon consultation. Antibiotic as policy, Proton pump inhibitors (omeprazole 40 mg once daily), Other supportive medication according to the needs of the condition, For postoperative pain routine care in the form of use of paracetamol (10mg/kg/8 hrs), and non-steroidal anti-inflammatory(ketorolac 30 mg /12 hrs ) medication and nalbuphine will be used till comfort of the patient. All doses will be adjusted according to body weight and organ function when required. Base line laboratory indices will be withdrawn including; CBC, Metabolic profile, liver function profile, renal function profile, ABG, INR.

The eligible patients will be randomly assigned into one of two groups through the random numbers, the random numbers will be used by a pharmacist who will prepare the different regimen. the data collector will be blind about the grouping intervention. A)intervention group ; post-operative within the first 3 hours the patient will receive 250 ml of peptide-based, semi-elemental protein( 250 ml Peptamen = 6 scoops (55g) + 210ml water ) repeated at ( 6, 8 , 10 , 12 hours postoperative ) in order to reach total protein in order to reach total protein 50 mg in the first 12 hour post-operative, Second day ordinary food will be introduced supplemented by half the dose of the first day from elemental protein (250 ml / 6 hours ) or to the dose to achieve the daily protein adequacy 1.3 mg/kg/day. B) Standard group; The patients in this group will receive the standard protocol in which they will be made NPO till the return of bowel functions. Thereafter, water and clear fluids will be given followed by soft food and, eventually a regular diet. Protein requirement in postpartum around 1g/kg reaching up to 1.9 gm/kg 11. The investigator will standardize the intake to 1.3g/kg.

In both groups intravenous fluid will be given according to hemodynamic in the form of ringer acetate with basal infusion 40ml/hr and will be adjusted according to hemodynamic parameters. In both groups, daily food and fluid record will be assessed by research assistant who will follow both the patient recall and the nurse record. The research assistant will be provided by written details in how to calculate protein and energy intake.

02

Conditions studied

  • Malnutrition in Pregnancy
  • Malnutrition; Protein
  • Postpartum Disorder
  • Patient Satisfaction
  • Critical Illness

Keywords

  • critical illness
  • nutrition therapy
  • Enhanced Recovery After Surgery
  • Enhanced Recovery After Caesarean section
03

In context

Kwashiorkor

45 studies on the registry are indexed under Kwashiorkor; 5 are open to participants now.

This study's enrollment of 83 is below the median of 100 across 33 interventional studies indexed under Kwashiorkor.

Browse Kwashiorkor studies →

Lead sponsor

Ain Shams University is the lead sponsor of 1,950 studies on the registry; 429 are open to participants now.

Of its 35 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
16 Years to 50 Years
Sexes eligible
Female
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

  • Critically ill Female patients with cesarean section with or without hysterectomy that requires ICU admission pre or postoperative

Exclusion criteria

Exclusion Criteria:

  • Decompensated heart failure,
  • Known allergy
  • Tryptophan intolerance
  • known inborn errors of metabolism of proteins as alkaptonuria
  • severe hepatic dysfunction (failure)
  • severe renal dysfunction (failure)
  • severe coagulopathy or DIC
  • circulatory shock or hemodynamic instability
  • Lactose intolerance
  • G6PD deficiency
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
83 participants (actual)

Study arms

  • Experimental
    peptide-based semi-elemental formula group

    peptide-based, semi-elemental group ; post-operative within the first 3 hours the patient will receive 250 ml of semi-elemental protein( 250 ml Peptamen = 6 scoops (55g) + 210ml water ) repeated at ( 6, 8 , 10 , 12 hours postoperative ) in order to reach total protein in order to reach total protein 50 mg in the first 12 hour post-operative, Second day ordinary food will be introduced supplemented by half the dose of the first day from semi-elemental protein (250 ml / 6 hours ) or to the dose to achieve the daily protein adequacy 1.3 mg/kg/day.

    Dietary Supplement: Elemental amino-acids

  • Active comparator
    standard

    Standard group; The patients in this group will receive the standard protocol in which they will be made NPO till the return of bowel functions. Thereafter, water and clear fluids will be given followed by soft food and, eventually a regular diet.

    Dietary Supplement: Elemental amino-acids

Interventions

  • Dietary supplementElemental amino-acids

    mono peptide oral protein formula

06

What researchers measure

Primary outcomes

  1. the protein intake

    total protein intake/day measurement tool is calculation based on protein content in the food intake list , and measured by gram/kg/day

    Time frame: 24 hours postoperative. If the patient stay extended more than a day, the intake of second 24 hours will be calculated,

  2. The energy intake

    total energy intake/day, The measurement tool is calculated by an experienced clinical nutrition pharmacist based on food and supplements intake in nursing records and patient recall, and measured by kcal/kg/day

    Time frame: 24 hours postoperative. If the patient stay extended more than a day, the intake of second 24 hours will be calculated

Secondary outcomes

  1. satisfaction and Patient reported outcome measures (PROMs) regarding recovery aspects (physical comfort- emotional state, physical independence and pain

    will be assessed using the Obstetric Quality of Recovery-10A survey tool and measured by units on the scale, it is 10 questions with answers on a scale from 0 to 10 where 0 =very poor and 10 = excellent. with cumulative score where \<71= poor, 71-88= moderate, \>88= excellent.

    Time frame: After 48 hours or at discharge from ICU which comes first

07

Study locations

1 site
  • Ain shams university
    Cairo, Cairo Governorate, Egypt
08

References and documents

Publications

  • Macones GA, Caughey AB, Wood SL, Wrench IJ, Huang J, Norman M, Pettersson K, Fawcett WJ, Shalabi MM, Metcalfe A, Gramlich L, Nelson G, Wilson RD. Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery (ERAS) Society recommendations (part 3). Am J Obstet Gynecol. 2019 Sep;221(3):247.e1-247.e9. doi: 10.1016/j.ajog.2019.04.012. Epub 2019 Apr 14. PubMed 30995461 ↗
  • Looijaard WGPM, Denneman N, Broens B, Girbes ARJ, Weijs PJM, Oudemans-van Straaten HM. Achieving protein targets without energy overfeeding in critically ill patients: A prospective feasibility study. Clin Nutr. 2019 Dec;38(6):2623-2631. doi: 10.1016/j.clnu.2018.11.012. Epub 2018 Dec 17. PubMed 30595377 ↗
  • Meyer R, Foong RX, Thapar N, Kritas S, Shah N. Systematic review of the impact of feed protein type and degree of hydrolysis on gastric emptying in children. BMC Gastroenterol. 2015 Oct 15;15:137. doi: 10.1186/s12876-015-0369-0. PubMed 26472544 ↗

Individual participant data

Plan to share: Yes — Deidentified data will be shared on reasonable request

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 11, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06164301
Responsible party
Sponsor
First posted
Dec 11, 2023
Start date
Apr 14, 2024
Primary completion
Jan 20, 2026
Completion
Mar 1, 2026
Last update
Mar 11, 2026

Study contacts

wessam selima, MD
principal investigator · assistant professor (lecturer)- Ain shams university

Oversight

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

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