Endogenous Energy Production in Critically Ill Patients

Launched by KAROLINSKA UNIVERSITY HOSPITAL · Jul 1, 2025

Keywords

ClinConnect Summary

This clinical trial is studying how critically ill patients use their own energy sources, like sugar, fat, and protein, especially when they are in the intensive care unit (ICU) and connected to a breathing machine. The researchers want to understand when these patients stop breaking down their own body tissues for energy and start responding normally to the nutrition they receive through IV feeding. To do this, they will measure how the body processes these nutrients both when patients are fasting and when they are being fed through an IV.

Adults who are in the ICU, on a breathing machine, and expected to stay for more than three days might be eligible to take part. Participants will have special blood tests done on at least two occasions to track how their bodies use energy and to look for markers that show when their metabolism starts to improve with feeding. People with certain conditions like liver disease, diabetes, pregnancy, or those who have been in the ICU for more than three days before joining won’t be able to participate. This study is not yet recruiting patients, but it aims to help doctors better understand how to support nutrition in very sick patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• For the ICU group:
• • 1. ≥18 years old and admitted to the ICU
• • 2. Invasive mechanical ventilation
• • 3. Arterial and central line in situ
• • 4. Expected to remain in ICU \>72 hours
• For the control group:
• • 1. ≥18 years old
• Exclusion Criteria:
• • 1. Lack of informed consent by patient/next of kin
• • 2. Liver transplant
• • 3. Acute or acute on chronic liver failure
• • 4. Cirrhosis
• • 5. Known diabetes mellitus
• • 6. Pancreatic surgery
• • 7. Acute or chronic pancreatitis
• • 8. Pregnancy
• • 9. Intubated only for airway protection or neurologic deficit
• • 10. Mitochondrial disease
• • 11. Disorder of amino acid metabolism
• • 12. Familial hypertriglyceridemia
• • 13. Severe acquired hypertriglyceridemia (≥10 mmol/L)
• • 14. Requiring treatment of hypoglycemia in the last 72 hours before inclusion.
• • 15. Requiring ongoing large volume resuscitation of crystalloids or blood products
• • 16. \>72 hours in ICU before enrollment
• • 17. Readmission to ICU within 1 week of ICU discharge.
• • 18. Morbidly obese (BMI ≥35)
• • 19. Limitations of treatment to best supportive care
• • 20. Ongoing treatment with insulin/glucose related to hyperkalemia