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Trial registered on ANZCTR
Registration number
ACTRN12609001058268
Ethics application status
Approved
Date submitted
4/12/2009
Date registered
10/12/2009
Date last updated
8/10/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
More amino acids for prevention of extrauterine growth retardation in very low birth weight infants. A randomized controlled trial.
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Scientific title
More amino acids for prevention of postnatal growth retardation in very low birth weight infants
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Secondary ID [1]
1177
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Growth of very low birth weight infants
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Condition category
Condition code
Reproductive Health and Childbirth
252534
252534
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0
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Complications of newborn
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
supplementation with essential aminoacids in addition to enteral and parenteral nutrition
The aminoacids administered were the following:
L- Istidina
L- Isoleucina
L- Leucina
L- Lisina
L- Metionina
L- Fenilalanina
L- Treonina
L- Triptofano
L- Valina
The formulation was on opened capsule containing dispersible powder that was added to the milk
The amount of aminoacids provided through enteral and parenteral nutrition, regardless of supplementation with essential amino acids, were the following:
Starting amminoacids intakes: 1.5 gr/kg
Daily increase: 0.5 gr/kg once a day
Total intakes of amminoacids (enteral and parenteral nutrition) nearly to 10 days of life: 3.5-4.0 gr/kg
The essential amminoacids, available as pharmaceutical formulation in capsule form, were delivered with the following schedule, taking into account the weight:
500-1000 gr: 1 gr/kg/once a day
1001-1500 gr: 0.8 gr/kg/once a day
1501 – 2000 gr: 0.5 gr/kg/once a day
Supplementation started on the recruitment, in the first 24 hours of life, and was ceased at discharge
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Intervention code [1]
255656
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Treatment: Drugs
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Comparator / control treatment
placebo.
placebo consisted of open capsules, similar to those of the drug, which contained 1 mg of sugar
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Control group
Placebo
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Outcomes
Primary outcome [1]
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z-score of weight, height and head circumference.
We measured the deviation of the infant?s growth by reference for weight, length and head circumference. The differences were expressed as z score
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Assessment method [1]
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Timepoint [1]
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at discharge from hospital
3, 6, 12 months of post concetional age (corrected age)
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Secondary outcome [1]
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days to regain birth weight (BW), duration of parenteral nutrition (PN), length of hospital stay, incidence of necrotizing enterocolitis (NEC), retinopaty of prematurity (ROP), chronic lung disease (CLD), intraventricular hemorrage (IVH), periventricular leukomalacia (PVL)
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Assessment method [1]
262524
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Timepoint [1]
262524
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at discharge from hospital
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Eligibility
Key inclusion criteria
birth weight < 1500 gr
obtaining informed consent from parents
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Minimum age
1
Hours
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Maximum age
3
Hours
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
major congenital abnormality including known
chromosomal abnormality
twin-twin transfusion
intra-uterine transfusion or exchange transfusion
Rhesus iso-immunisation
significant multi-organ failure prior to trial entry
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Italy
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State/province [1]
2352
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Funding & Sponsors
Funding source category [1]
256134
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
256134
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Italy
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Primary sponsor type
Hospital
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Name
Osp. Buon Consiglio
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Address
Via A. Manzoni, 220 Naples
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Country
Italy
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
251474
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Ethics approval
Ethics application status
Approved
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Summary
Brief summary
The preterm infant misses the last trimester of fetal nutrient accretion and requirement for immediate nutrient delivery that included amino acids may be essential due to limited glycogen and fat reserves. Significant nutrient deficiencies are observed in the neonatal intensive care unit and premature infants are frequently discharged at weights less than the 10th percentile. Perhaps more concerning than low discharge weights is the association of poor growth in the early weeks of hospitalization with abnormal neurodevelopment and an increased prevalence of cerebral palsy. The goal of early amino-acid supplementation is to provide the preterm infant with intravenous substrate that promotes protein deposition and increased lean body mass that more closely approximates fetal energy production and growth. Several previous investigations have demonstrated the beneficial effect of early parenteral amino acids on decreasing protein loss in preterm infants However, despite aggressive nutrition with high intakes of amino acids in the first hours of life, for some essential aminoacids it is impossible to reach in very low birth weight (VLBW) infants levels similar to those observed in human fetus during the second and third trimesters of pregnancy. We presumed that the lower concentrations of essential amminoacids limited protein accretion and growing performance of VLBW infants. We would like to see the effect of administration of essential amino acids on the growth of VLBW infants
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Gennaro Salvia, MD
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Address
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Via A. Manzoni, 220 Naples
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Country
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Italy
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Phone
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+39813384105391
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Gennaro Salvia, MD
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Address
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Via A. Manzoni, 220 Naples
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Country
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Italy
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Phone
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+39813384105391
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Fax
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Email
4757
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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