NCT07630090

Brief Summary

This randomized controlled trial aims to compare the effectiveness of early post-pyloric feeding versus gastric feeding in preventing SAP in patients with severe ischemic stroke. The main question to answer is whether post-pyloric feeding group is better than the gastric feeding group for preventing SAP.

Trial Health

63
Monitor

Trial Health Score

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

Enrollment
174

participants targeted

Target at P25-P50 for phase_4 stroke

Timeline
15mo left

Started Jun 2026

Shorter than P25 for phase_4 stroke

Geographic Reach
1 country

1 active site

Status
not yet recruiting

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

May 27, 2026

Completed
9 days until next milestone

First Posted

Study publicly available on registry

June 5, 2026

Completed
10 days until next milestone

Study Start

First participant enrolled

June 15, 2026

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 16, 2027

Expected
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 15, 2027

Last Updated

June 5, 2026

Status Verified

May 1, 2026

Enrollment Period

1 year

First QC Date

May 27, 2026

Last Update Submit

June 1, 2026

Conditions

Keywords

Gastric FeedingNIHSSsevere strokePost-Pyloric Feedingstroke-associated pneumonia

Outcome Measures

Primary Outcomes (1)

  • Incidence of stroke-associated pneumonia within 7 days of onset

    The diagnostic criteria for SAP will follow the 2019 Chinese Expert Consensus on the Diagnosis and Treatment of Stroke-Associated Pneumonia.

    7 days of onset.

Secondary Outcomes (7)

  • Hospital length of stay

    From date of admission to date of discharge, assessed up to 28 days

  • 90-day modified Rankin Scale (mRS) score

    90 days after randomization

  • Time from admission to achieving enteral nutrition target

    From date of admission until enteral nutrition target is achieved, assessed up to 28 days

  • Change from baseline in serum albumin level at Day 14

    Baseline and Day 14

  • Change from baseline in serum albumin level at Day 28

    Baseline and Day 28

  • +2 more secondary outcomes

Other Outcomes (15)

  • Mortality within 28 days

    28 days post-randomization.

  • Incidence of Gastrointestinal Complications

    28 days

  • Catheter-related Complications

    28 days

  • +12 more other outcomes

Study Arms (2)

Post-Pyloric Feeding Group

EXPERIMENTAL

A nasoenteric tube (Nuritia, 10Fr) will be placed within 24 hours of admission. The procedure involves elevating the head of the bed to approximately 30-45°, lubricating the tube with liquid paraffin, inserting it into the stomach using a blind insertion technique, then positioning the patient in the right lateral decubitus position. The insertion length will be approximately 75 cm. 200-500 ml of air and warm water will be injected into the stomach to open the pylorus. Gently, as the pylorus opens, the tube will be advanced beyond the ligament of Treitz. Digestive fluid will be aspirated for pH testing. Tube position (post-pyloric) will be confirmed by X-ray before initiating enteral nutrition support. An appropriate nutritional formula will be selected based on the patient's condition. The initial infusion rate will be 20 ml/h using a nutrition pump. The head of the bed will be elevated to 30-45°. Observation will occur continuously for the first hour, then every 4 hours. The rate wi

Procedure: Post-Pyloric Feeding

Gastric Feeding Group

ACTIVE COMPARATOR

A nasogastric tube (Nuritia, 14Fr) will be placed within 24 hours of admission. The tube will be lubricated with liquid paraffin, inserted into the gastric cavity using a blind insertion technique, and properly fixed. Correct position will be confirmed by auscultation of air insufflation over the stomach before initiating enteral nutrition support. An appropriate nutritional formula will be selected based on the patient's condition. The initial infusion rate will be 20 ml/h using a nutrition pump. The head of the bed will be elevated to 30-45°. Observation will occur continuously for the first hour, then every 4 hours. The rate will be gradually increased by 10 mL every 4 hours based on patient tolerance until the daily target volume (25-30 kcal/kg/day) is achieved.

Procedure: Gastric Feeding

Interventions

A nasoenteric tube (Nuritia, 10Fr) will be placed within 24 hours of admission. The procedure involves elevating the head of the bed to approximately 30-45°, lubricating the tube with liquid paraffin, inserting it into the stomach using a blind insertion technique, then positioning the patient in the right lateral decubitus position. The insertion length will be approximately 75 cm. 200-500 ml of air and warm water will be injected into the stomach to open the pylorus. Gently, as the pylorus opens, the tube will be advanced beyond the ligament of Treitz. Digestive fluid will be aspirated for pH testing. Tube position (post-pyloric) will be confirmed by X-ray before initiating enteral nutrition support. An appropriate nutritional formula will be selected based on the patient's condition. The initial infusion rate will be 20 ml/h using a nutrition pump. The head of the bed will be elevated to 30-45°. Observation will occur continuously for the first hour, then every 4 hours. The rate wil

Post-Pyloric Feeding Group

A nasogastric tube (Nuritia, 14Fr) will be placed within 24 hours of admission. The tube will be lubricated with liquid paraffin, inserted into the gastric cavity using a blind insertion technique, and properly fixed. Correct position will be confirmed by auscultation of air insufflation over the stomach before initiating enteral nutrition support. An appropriate nutritional formula will be selected based on the patient's condition. The initial infusion rate will be 20 ml/h using a nutrition pump. The head of the bed will be elevated to 30-45°. Observation will occur continuously for the first hour, then every 4 hours. The rate will be gradually increased by 10 mL every 4 hours based on patient tolerance until the daily target volume (25-30 kcal/kg/day) is achieved.

Gastric Feeding Group

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Age ≥ 18 years
  • Diagnosis of severe ischemic stroke, with NIHSS score \> 16 \[15-16\]
  • Confirmed dysphagia via swallowing assessment (Kubota Water Swallowing Test ≥ grade 3, or confirmed aspiration risk by FEES/VFSS)
  • Time from onset to enrollment ≤ 72 hours
  • Expected survival ≥ 7 days
  • Non-mechanically ventilated patients
  • Signed informed consent from patient or legal representative.

You may not qualify if:

  • Diagnosed with pneumonia upon admission
  • High risk of gastrointestinal bleeding or perforation
  • Intestinal obstruction or gastrointestinal obstruction
  • Severe liver or kidney dysfunction
  • Advanced malignant tumor
  • Pregnancy or breastfeeding
  • Refusal to participate in the study

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Jinling Hospital, Medical School of Nanjing University, Nanjing

Nanjing, Jiangsu, 210002, China

Location

MeSH Terms

Conditions

Stroke

Interventions

Enteral Nutrition

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Intervention Hierarchy (Ancestors)

Feeding MethodsTherapeuticsNutritional SupportNutrition Therapy

Study Officials

  • Wusheng Zhu, MD

    Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Head of Neurology

Study Record Dates

First Submitted

May 27, 2026

First Posted

June 5, 2026

Study Start

June 15, 2026

Primary Completion (Estimated)

June 16, 2027

Study Completion (Estimated)

September 15, 2027

Last Updated

June 5, 2026

Record last verified: 2026-05

Data Sharing

IPD Sharing
Will not share

Patient information will be de-identified

Locations