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Trial registered on ANZCTR
Registration number
ACTRN12625000319471
Ethics application status
Approved
Date submitted
28/11/2024
Date registered
17/04/2025
Date last updated
17/04/2025
Date data sharing statement initially provided
17/04/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of Inulin supplementation on gastrointestinal microbiota in critical illness
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Scientific title
Inulin supplementation and gastrointestinal microbiota outcomes in mechanically ventilated adults: a pilot randomized controlled trial (INTESTINAL)
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Secondary ID [1]
313482
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Nil
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Universal Trial Number (UTN)
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Trial acronym
INTESTINAL
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Critical illness
335894
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Condition category
Condition code
Neurological
332483
332483
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0
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Other neurological disorders
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Respiratory
332481
332481
0
0
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Other respiratory disorders / diseases
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Infection
332480
332480
0
0
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Other infectious diseases
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Blood
332489
332489
0
0
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Other blood disorders
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Surgery
332485
332485
0
0
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Other surgery
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Cardiovascular
332482
332482
0
0
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Other cardiovascular diseases
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Oral and Gastrointestinal
332486
332486
0
0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Metabolic and Endocrine
332487
332487
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0
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Metabolic disorders
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Renal and Urogenital
332484
332484
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The dose administered: 10 grams of Inulin dissolved in 50mL of water.
The mode of administration: as a bolus through an existing nasogastric tube (or orally once extubated)
The frequency and duration of this intervention: once daily for 7 days (only while in ICU)
This intervention will commence as soon as possible after patient is mechanically ventilated, consent obtained from medical treatment decision maker (MDTM) and allowed enteral nutrition.
Adherence to administration of intervention will be by monitoring EMR.
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Intervention code [1]
330057
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Treatment: Other
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Comparator / control treatment
50mL of water as a bolus through an existing nasogastric tube (or orally once extubated)
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Intra-individual change to GI microbiota - Alpha diversity and/or increased abundance of SCFA-producing taxa (Roseburia, Ruminococcus, Faecalibacterium, Bifidobacteria) will be assessed as a composite outcome
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Assessment method [1]
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Metagenomic whole genome sequencing and taxonomic and functional profiling will be performing using the analysis tools Kraken2 and HUMAnN3.
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Timepoint [1]
340014
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Baseline (on randomisation), day 3 and day 7 post randomisation.
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Secondary outcome [1]
442335
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Incidence of diarrhoea (days of diarrhoea) and incident use of faecal management system; this will be assessed as a composite outcome.
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Assessment method [1]
442335
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Defined by the WHO criteria; data will be extracted from the electronic medical records.
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Timepoint [1]
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Data for 7-day study period will be extracted at Day 7 post-commencement of intervention
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Secondary outcome [2]
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Prevalence of symptoms or features consistent with excessive gas formation in the abdomen such as abdominal distension, bowel obstruction or ileus
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Assessment method [2]
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Large language model assessment of clinical notes
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Timepoint [2]
442337
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Data for 7-day study period will be extracted at Day 7 post-commencement of intervention
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Secondary outcome [3]
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Prevalence of enteral feed intolerance
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Assessment method [3]
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Defined as a single gastric residual volume (GRV) >500ml or need for administration of gastrokinetic drugs (metoclopramide or erythromycin), diarrhoea, constipation. Data will be extracted from patient medical records.
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Timepoint [3]
442336
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Data for 7-day study period will be extracted at Day 7 post-commencement of intervention
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Eligibility
Key inclusion criteria
a. Adults greater than or equal to 18 years of age
b. Admitted to ICU
c. Expected to remain Mechanically ventilated for 48 hrs
d. Allowed enteral nutrition at the time of randomization
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Minimum age
18
Years
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Maximum age
No limit
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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
a. Death during ICU admission deemed to be inevitable
b. Patients unable to be fed enterally
c. Pregnancy
d. Surgery involving the GI lumen in the preceding 30 days
e. Currently has a colostomy or ileostomy
f. Pregnancy or lactation
g. Has received enteral nutrition for more than 72 hrs prior to randomisation
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Study design
Purpose of the study
Treatment
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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)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
central, variable block size via online randomisation engine
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
5/05/2025
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Actual
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Date of last participant enrolment
Anticipated
5/06/2028
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Actual
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Date of last data collection
Anticipated
30/06/2028
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Actual
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Sample size
Target
50
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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The Northern Hospital
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Address [1]
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Country [1]
317923
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Australia
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Funding source category [2]
318710
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Other Collaborative groups
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Name [2]
318710
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The Doherty Institute
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Address [2]
318710
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Country [2]
318710
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Australia
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Funding source category [3]
318709
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Hospital
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Name [3]
318709
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Royal Melbourne Hospital
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Address [3]
318709
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Country [3]
318709
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Australia
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Primary sponsor type
Hospital
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Name
Royal Melbourne Hospital
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Address
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Country
Australia
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Secondary sponsor category [1]
321139
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None
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Name [1]
321139
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Address [1]
321139
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Country [1]
321139
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
316608
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The Royal Melbourne Hospital Human Research Ethics Committee
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Ethics committee address [1]
316608
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https://www.thermh.org.au/research/researchers/ethics
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Ethics committee country [1]
316608
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Australia
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Date submitted for ethics approval [1]
316608
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28/09/2024
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Approval date [1]
316608
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11/11/2024
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Ethics approval number [1]
316608
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Summary
Brief summary
This study will aim to establish whether dietary fibre added to normal tube feeding food can increase bacterial diversity in the GI tract in people who are critically ill and are receiving treatment with a breathing machine in the ICU. Information on GI bacteria will be collected from stool samples or cotton swabs that have wiped the bottom. It will also aim to collect information on whether the use of use of dietary fibre can lead to patients improving more quickly, such as by enabling liberation from the breathing machine earlier or having fewer infections caught in hospital. This study aims to investigate if "good bacteria" in the intestines can be increased during critical illness adding fibre to food.
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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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Dr ANGAJ GHOSH
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Address
138402
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The Northern Hospital, 185 COOPER STREET, EPPING, VICTORIA 3076
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Country
138402
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Australia
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Phone
138402
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+61 03 8468 8264
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Fax
138402
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Email
138402
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[email protected]
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Contact person for public queries
Name
138403
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ANGAJ GHOSH
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Address
138403
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The Northern Hospital, 185 COOPER STREET, EPPING, VICTORIA 3076
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Country
138403
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Australia
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Phone
138403
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+61 03 8468 8264
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Fax
138403
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Email
138403
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[email protected]
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Contact person for scientific queries
Name
138404
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ANGAJ GHOSH
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Address
138404
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The Northern Hospital, 185 COOPER STREET, EPPING, VICTORIA 3076
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Country
138404
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Australia
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Phone
138404
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+61 03 8468 8264
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Fax
138404
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Email
138404
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
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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