NCT05457712

Brief Summary

Introduction: The use of a nutritional protocols provides the standardization of assessment procedures and the optimization of nutritional status recovery of pre-surgical infants with Congenital Heart Disease (CHD). However, to our knowledge there are no validated instrument for presurgical nutritional support for infants with congenital heart disease (CHD) in Brazil. Objective: Assess the clinical effectiveness of the translated and cross-culturally adapted protocol, Nutritional Pathway for Infants with Congenital Heart Disease before Surgery (Marino et al., 2018), on the weight change of infants with congenital heart disease in two specialized cardiology hospitals in Southern Brazil in partnership with the UK research group that authored the original of protocol. Methods: A randomized, pragmatic clinical trial will be carried out. The sample will consist of children with CHD, between 0-12 months of age, awaiting cardiovascular corrective surgery from the Pediatric Outpatient Clinic in the Institute of Cardiology (IC) and Children's Hospital Santo Antonio of Santa Casa de Misericordia. The previously translated pre-surgical nutritional intervention protocol for infants with congenital heart disease will be compared with current routine nutritional guidelines used in the follow-up services of children with congenital heart disease in these institutions within the national public healthcare, SUS. Intended results: It is expected that the culturally-adapted pre-surgical nutritional support protocol for children with congenital heart disease will be effective in pre-surgical infant weight gain, which will likely improve surgical prognosis and clinical outcomes. And we hope that this protocol will promote the standardization of care, and will provide an empirically-based nutritional intervention that may improve the effectiveness of nutritional recovery in the CHD infants. Furthermore, the results may be used in the formulation of Brazilian guidelines for comprehensive care of children with congenital heart disease.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
118

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2023

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 18, 2022

Completed
4 months until next milestone

First Posted

Study publicly available on registry

July 14, 2022

Completed
6 months until next milestone

Study Start

First participant enrolled

January 9, 2023

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 2, 2024

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

May 2, 2024

Completed
Last Updated

July 14, 2022

Status Verified

July 1, 2022

Enrollment Period

1.2 years

First QC Date

March 18, 2022

Last Update Submit

July 11, 2022

Conditions

Keywords

Heart Defects, CongenitalInfantPreoperative CareNutritional Support

Outcome Measures

Primary Outcomes (1)

  • changing the nutritional status

    Effectiveness of the cross-culturally adapted protocol on changing the nutritional status of babies with congenital heart disease

    change in nutritional status after 60 days of preoperative intervention

Study Arms (2)

Intervention group

EXPERIMENTAL

In the first evaluation and after the patient's consent, a standardized complementary questionnaire will be applied, with demographic and clinical information. The nutritionist will carry out the anthropometric assessment, questionnaires and application of the protocol for this group. The energy and protein value of the prescribed diet will be followed according to the original protocol considering plans A, B or C, via a hypercaloric formula with a caloric density of 1kcal/ ml for infants starting 60 days preoperatively. The return for nutritional monitoring will take place after evaluation: weekly, biweekly or monthly.

Dietary Supplement: protocol

Control group

OTHER

In the first evaluation and after the patient's consent, a standardized complementary questionnaire will be applied, with demographic and clinical information. The nutritionist will carry out the anthropometric assessment and questionnaires. Afterwards, they will be evaluated through the standard nutritional protocol of the nutrition clinic of the Institute of Cardiology and Children's Hospital Santo Antonio of Porto Alegre, whose standard nutritional prescription is a polymeric formula with a caloric density of 0.67 kcal/ml. Nutritional monitoring will take place through telephone contact for information on the baby's clinical data and in person before the surgery is performed.

Other: Control

Interventions

protocolDIETARY_SUPPLEMENT

The energy and protein value of the prescribed diet will be followed according to the original protocol considering plans A, B or C, via a hypercaloric formula with a caloric density of 1kcal/ml for infants starting 60 days preoperatively. The return for nutritional monitoring will take place after evaluation: weekly, biweekly or monthly.

Intervention group
ControlOTHER

Afterwards, they will be evaluated through the standard nutritional protocol of the nutrition clinic of the Instituto de Cardiologia de and Hospital Santo Antonio de Porto Alegre, whose standard nutritional prescription is a polymeric formula with a caloric density of 0.67 kcal/ml. Nutritional monitoring will take place through telephone contact for information on the baby's clinical data and in person before the surgery is performed.

Control group

Eligibility Criteria

Age30 Days - 12 Months
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • Children with a diagnosis of congenital heart disease aged between zero and twelve months, awaiting surgery for cardiac correction, classified in risk category 1 of the RACHS-1 score;
  • Term birth;

You may not qualify if:

  • Patients with:
  • Neurological impairment;
  • Craniofacial malformation;
  • Structural alterations of the upper airways;
  • Respiratory impairment;
  • Suspicion or diagnosis of genetic syndrome;
  • Any type of food allergy.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (1)

  • Marino LV, Johnson MJ, Hall NJ, Davies NJ, Kidd CS, Daniels ML, Robinson JE, Richens T, Bharucha T, Darlington AE; British Dietetic Association Paediatric Cardiology Interest Group. The development of a consensus-based nutritional pathway for infants with CHD before surgery using a modified Delphi process. Cardiol Young. 2018 Jul;28(7):938-948. doi: 10.1017/S1047951118000549. Epub 2018 Apr 29.

    PMID: 29704905BACKGROUND

Related Links

MeSH Terms

Conditions

Heart Defects, CongenitalThinness

Interventions

Clinical Protocols

Condition Hierarchy (Ancestors)

Cardiovascular AbnormalitiesCardiovascular DiseasesHeart DiseasesCongenital AbnormalitiesCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesBody WeightSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

TherapeuticsEpidemiologic Study CharacteristicsHealth Care Evaluation MechanismsQuality of Health CareHealth Care Quality, Access, and Evaluation

Study Officials

  • Fernanda Lucchese, PhD

    Instituto de Cardiologia do Rio Grande do Sul

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Fernanda Lucchese, PhD

CONTACT

Viviane P Campos, Master

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
Due to the nature of the intervention, full blinding will not be possible. However, the statistical analysis team will be blinded.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Randomized clinical trial, pragmatic, with blind evaluation of outcomes.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
PHD

Study Record Dates

First Submitted

March 18, 2022

First Posted

July 14, 2022

Study Start

January 9, 2023

Primary Completion

April 2, 2024

Study Completion

May 2, 2024

Last Updated

July 14, 2022

Record last verified: 2022-07

Data Sharing

IPD Sharing
Will not share