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Trial registered on ANZCTR
Registration number
ACTRN12621000835842p
Ethics application status
Submitted, not yet approved
Date submitted
7/05/2021
Date registered
30/06/2021
Date last updated
30/06/2021
Date data sharing statement initially provided
30/06/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Weight gain in newborns following the adoption of the stoma refeeding technique
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Scientific title
Weight gain following the adoption of the chyme recycling technique in neonates with a high output stoma.
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Secondary ID [1]
304156
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The Insides Company trial register number ETRR-11
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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:
malnutrition
321848
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high-output stoma
321849
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intestinal failure
321850
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Condition category
Condition code
Reproductive Health and Childbirth
319574
319574
0
0
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Complications of newborn
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Oral and Gastrointestinal
319575
319575
0
0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Diet and Nutrition
319576
319576
0
0
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Other diet and nutrition disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Neonates with high-output stomas will be treated with chyme recycling through a standardised protocol. It includes the use of a novel device purposefully designed for this procedure. The device consists of a valve connected to a 5 ml syringe and a stoma bag. The valve will prevent the reinfused chyme from flowing back to the stoma bag. Patients will have their distal stoma limbs catheterised. The Catheter will be used by the clinical team (trained nurses) will reinfuse part of the chyme output from the proximal limb. The goal is to reinfuse as much enteric content as possible. The amount of chyme being discarded will be recorded. Each participant will experience the intervention four to six times a day on average. A secondary outcome that will be studied is the impact of the intervention on distal stoma atrophy, which may reduce anatomical incompatibility, thus reducing complications following the restoration of bowel continuity. This feature may give the rehabilitation characteristic of the device. The study will last for the duration of the neonate stay in the NICU. The adherence to the protocol will be followed by a researcher, who will visit the participants and will be in close contact with the clinical team. If any potential complications possibly from the interventions arise, they will be discontinued. Instead, the patients will be offered the standard treatment which includes chyme recycling using repurposed materials. If they cannot tolerate the procedure, they will be offered parenteral nutrition and the enteral material will be discarded.
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Intervention code [1]
320488
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Treatment: Devices
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Intervention code [2]
320489
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Treatment: Other
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Comparator / control treatment
There will be no control group, The researchers will compare clinical features observed before and the outcomes after the intervention.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Receipt of enteral nutrition as assessed from hospital records.
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Assessment method [1]
327434
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Timepoint [1]
327434
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Enteral nutrition prescriptions assessed daily until discharge from NICU for a maximum of 90 days
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Primary outcome [2]
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Receipt of parenteral nutrition as assessed from hospital records.
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Assessment method [2]
327435
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Timepoint [2]
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Parenteral nutrition prescriptions assessed daily until discharge from NICU for a maximum of 365 days
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Primary outcome [3]
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Weight change assessed from hospital records
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Assessment method [3]
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Timepoint [3]
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Weight change assessed from hospital records weekly until discharge from NICU for a maximum of 365 days.
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Secondary outcome [1]
395126
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Evaluate distal stoma atrophy by measuring the proximal and distal enterostomy diameters at the time of the stoma reversal procedure. The stomas will be measured in centimetres using a sterile tape measure during the stoma reversal surgery.
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Assessment method [1]
395126
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Timepoint [1]
395126
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enterostomies diameters will be measured once immediately before the reversal procedure.
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Eligibility
Key inclusion criteria
1. Neonates with one or more small intestine stomas or entero-atmospheric fistula(s)
2. Sufficient distal tract length able to handle chyme or enteral nutrition
3. Guardian able to understand the risks/benefits of the study as well as giving consent to their children's participation.
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Minimum age
0
Days
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Maximum age
3
Months
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Distal obstruction, anastomotic leak
2. Inability to tolerate chyme reinfusion or enteral feeding.
3. Clinical concern for ischaemic gut
4. Inability to safely intubate the distal stoma.
5. Septic or critically unwell patient
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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)
N/A
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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
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Statistical analyses will consist of a comparison of key clinical features before and after the intervention
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/07/2021
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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
20
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
23679
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New Zealand
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State/province [1]
23679
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Auckland
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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The Insides Company Limited
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Address [1]
308528
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487 Parnell Road, Auckland, 1052
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Country [1]
308528
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New Zealand
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Primary sponsor type
Commercial sector/Industry
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Name
The Insides Company
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Address
487 Parnell Road, Auckland, 1052
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Country
New Zealand
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Secondary sponsor category [1]
309391
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None
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Name [1]
309391
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Address [1]
309391
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Country [1]
309391
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
308483
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Northern B HDEC
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Ethics committee address [1]
308483
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133 Molesworth Street Thorndon Wellington 6011
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Ethics committee country [1]
308483
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New Zealand
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Date submitted for ethics approval [1]
308483
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26/01/2021
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Approval date [1]
308483
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Ethics approval number [1]
308483
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Summary
Brief summary
Some newborns present with a rare condition called intestinal failure, which often requires a temporary stoma. With the aim of reducing complications associated with the type of nutritional support offered to these patients, a novel protocol has been proposed. It consists of reinfusing enteric content back to the bowel. We hypothesise this technique will enable newborns to gain weight, reduce infections, and shorten the length of their NICU stay.
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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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Mr Andre Modesto
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Address
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The University of Auckland
22-30 Park Avenue, Grafton, Auckland 1023
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Country
110854
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New Zealand
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Phone
110854
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+64 223596027
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Fax
110854
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Email
110854
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[email protected]
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Contact person for public queries
Name
110855
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Greg O'Grady
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Address
110855
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The University of Auckland
22-30 Park Avenue, Grafton, Auckland 1023
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Country
110855
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New Zealand
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Phone
110855
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+64 274222989
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Fax
110855
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Email
110855
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[email protected]
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Contact person for scientific queries
Name
110856
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Greg O'Grady
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Address
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The University of Auckland
22-30 Park Avenue, Grafton, Auckland 1023
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Country
110856
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New Zealand
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Phone
110856
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+64 274222989
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Fax
110856
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Email
110856
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
11605
Study protocol
381949-(Uploaded-07-05-2021-09-13-44)-Study-related document.docx
11606
Informed consent form
381949-(Uploaded-07-05-2021-09-14-13)-Study-related document.docx
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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