How far do we go with catching up study nutrition?
Only the nutrional deficit of the previous treatment day will need to be catched up during the next treatment day. For example, a patient with a daily target volume of 1500mL only received 1300mL. The deficit of this treatment day would be 200mL, This deficit will need to be cathed up during the next treatment day, implying that the daily target volume of the next treatment day is 1700mL (=1500mL + 200mL). Suppose that the patient received 1600mL instead of 1700mL on this day. In this case, the catch-up was not fully reached, yet the daily target of 1500ml was reached. No catch-up feeding will need to be performed any more.
When should we begin to resupply study nutrition?
It is recommended to check the supply of study nutrition weekly and order new study nutrition in time. The inclusion rate and number of enrolled PRECISe patients, requiring study nutrition on your ICU, will determine how fast your supplies run out. In case you are uncertain whether or not to order new study nutrition, please contact the PRECISe hotline.
How do we tackle the COVID-19 pandemic for PRECISe patients, and especially when on-site follow-up visits will become difficult?
From a scientific point of view, it would be interesting to enrol COVID-19 patients in the PRECISe study. COVID-19 patients are allowed to be included, and if practically feasible, we encourage you to do so. If follow-up visits cannot take place in the hospital during the COVID-19 pandemic, we enforece you to retrieve as much data as possible by phone. Questionnaires can be performed by phone, electronically via the eCRF or can be sent via regular mail.
How can we estimate the patient's height if unknown at admission?
You can either ask the patient's proxy (if available), or use a tape measure to measure the patient's height.
Can the questionnaires be performed by phone?
Questionnaires can be performed by phone. Nonetheless, we would like to stress the importance of the physical measurements, including the 6-minute walk test, the handgrip strength and the MRC-SUM test. These measurements can only be done when a follow-up visit is done in an outpatient setting. If an on-site visit is not possible, all efforts should be made to collect the questionnaires (and in specific the EQ5D-questionnaire). This can be done electronically (via the eCRF), on paper (via mail) or by phone.
Does a (treatment) day changes at 00:00 hrs or 24 hours after day 1 started?
The screening data for the calculation of the ICU scores (APACHE II and SOFA score) need to be collected within the first 24 hours after ICU admission, regardless of the time of ICU admission and the moment enteral feeding started. The treatment phase starts when enteral nutrition is initiated. The way a treatment day is calculated is site-dependent (e.g. 00h00 until 23h59 on the respective treatment day, or 06h00 on the respective treatment day until 05h59 on the next treatment day, etc.).
To illustrate: A patient is admitted to the ICU on 01 April 2020 at 15h00 and receives study feeding on 02 April 2020 at 11h00.
The window to calculate the ICU scores at screening will be from 01 April 2020 (15h00) until 02 April 2020 (14h59).
Treatment day 1 is on 02 April 2020. Depending on the site, treatment day encompasses the time between 02 April 2020 (00h00) until 02 April 2020 (23h59) or from 02 April 2020 (06h00) until 03 April 2020 (05h59).