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Vitamin C and Zinc in Patients With Enterocutaneous Fistulas. (VITAC)

Primary Purpose

Enterocutaneous Fistulas

Status
Recruiting
Phase
Not Applicable
Locations
Mexico
Study Type
Interventional
Intervention
Low-dose vitamin C and zinc
High-dose vitamin C and zinc
Sponsored by
Hospital Juarez de Mexico
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Enterocutaneous Fistulas focused on measuring enterocutaneous fistulas, Vitamin C, Zinc, Parenteral nutrition

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Women and men >18 years and <70 years old. Diagnosis of high-output enterocutaneous fistula for the first time Need for parenteral nutrition Exclusion Criteria: Octreotide use Palliative care Steroid use Oxalate nephropathy G6PD deficiency Hemochromatosis Abdominal surgeries in the last 6 months Hospitalizations for more than 15 days in the last 6 months

Sites / Locations

  • Hospital Juárez de MéxicoRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Sham Comparator

Active Comparator

Arm Label

Vit C y zinc bajo

Vit C and zinc alto

Arm Description

Parenteral nutrition + Vitamin C 100-300 mg/d y zinc 3-5 mg/d

Parenteral nutrition + Vitamin C 1000-2000 mg/d y zinc 10-15 mg/d

Outcomes

Primary Outcome Measures

Fistula closure
Evaluate enterocutaneous fistula closure rate.
Recurrence of fistula
Evaluate the recurrence of enterocutaneous fistula

Secondary Outcome Measures

Medical-nutritional status
Medical-nutritional status: subjective global assessment
Medical-nutritional status
Medical-nutritional status: nutritional risk index
biochemical markers
Changes in nutritional status biochemical markers: albumin in serum
biochemical markers
Changes in nutritional status biochemical markers: lymphocytes in serum.
biochemical markers
Changes in nutritional status biochemical markers: prealbumin in serum.
biochemical markers
Changes in nutritional status biochemical markers: transferrin in serum.
Metabolic profile
Changes in metabolic profile in serum glucose concentration
Metabolic profile
Changes in metabolic profile in serum tests liver
Length of hospital stay of patients
Determine the length of hospital stay of patients.

Full Information

First Posted
July 16, 2023
Last Updated
August 20, 2023
Sponsor
Hospital Juarez de Mexico
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1. Study Identification

Unique Protocol Identification Number
NCT06009744
Brief Title
Vitamin C and Zinc in Patients With Enterocutaneous Fistulas.
Acronym
VITAC
Official Title
Effectiveness of Doses of Vitamin c and Zinc in Patients With High Enterocutaneous Fistulas Receiving Nutrition Parenteral Therapy on Closure and Recurrence. Randomized Clinical Trial.
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 2023 (Anticipated)
Primary Completion Date
December 31, 2028 (Anticipated)
Study Completion Date
December 31, 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Hospital Juarez de Mexico

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Various micronutrients play an important role in the process of closure and recurrence of enterocutaneous fistulas, such as Vitamin C and Zinc. However, there is no specific recommendation on the dose of these nutrients by parenteral route.
Detailed Description
This is a randomized, control trial to investigate the effect and safety of doses of vitamin c and zinc in patients with high enterocutaneous fistulas receiving who need nutrition parenteral therapy on closure and recurrence. Screening will be made to select eligible participants before intervention. Participants were randomly assigned to one of two groups: group a) 25-35 kcal/K/d, 1.3-1.5 g/K/d of amino acids and C 100-300 mg/d y zinc 3-5 mg/d; group b) 25-35 kcal/K/d, 1.3-1.5 g/K/d of amino acids and Vitamin C 1000-2000 mg/d y zinc 10-15 mg/d. Demographic variables and subjective global assessment scale will be recorded and applied. Anthropometric measurements (weight and body mass index) will be evaluated upon admission and weekly until hospital discharge. Biochemical markers (albumin, lymphocytes, prealbumin, transferrin, cholesterol, creatinine) and serum metabolic profile (glucose, liver function test) will be measured weekly. During hospitalization, patients will be evaluated daily until the closure of the fistula and/or follow-up at 30 days, monitoring capillary blood glucose, insulin expenditure, and fistula volume.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Enterocutaneous Fistulas
Keywords
enterocutaneous fistulas, Vitamin C, Zinc, Parenteral nutrition

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Group a) 25-35 kcal/K/d, 1.3-1.5 g/K/d of amino acids and C 100-300 mg/d y zinc 3-5 mg/d Group b) 25-35 kcal/K/d, 1.3-1.5 g/K/d of amino acids and Vitamin C 1000-2000 mg/d y zinc 10-15 mg/d.
Masking
ParticipantCare ProviderOutcomes Assessor
Allocation
Randomized
Enrollment
76 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Vit C y zinc bajo
Arm Type
Sham Comparator
Arm Description
Parenteral nutrition + Vitamin C 100-300 mg/d y zinc 3-5 mg/d
Arm Title
Vit C and zinc alto
Arm Type
Active Comparator
Arm Description
Parenteral nutrition + Vitamin C 1000-2000 mg/d y zinc 10-15 mg/d
Intervention Type
Drug
Intervention Name(s)
Low-dose vitamin C and zinc
Other Intervention Name(s)
Low Vit C y zinc
Intervention Description
This is a randomized, control trial to investigate the effect of Vitamin C and Zinc in patients with enterocutaneous fistulas receiving nutrition parenteral therapy and Vitamin C 100-300 mg/d and zinc 3-5 mg/d
Intervention Type
Drug
Intervention Name(s)
High-dose vitamin C and zinc
Other Intervention Name(s)
High Vit C y zinc
Intervention Description
This is a randomized, control trial to investigate the effect of Vitamin C and Zinc in patients with enterocutaneous fistulas receiving nutrition parenteral therapy and Vitamin C 1000-2000 mg/d y zinc 10-15 mg/d
Primary Outcome Measure Information:
Title
Fistula closure
Description
Evaluate enterocutaneous fistula closure rate.
Time Frame
follow-up at 30 days
Title
Recurrence of fistula
Description
Evaluate the recurrence of enterocutaneous fistula
Time Frame
follow-up at 30 days
Secondary Outcome Measure Information:
Title
Medical-nutritional status
Description
Medical-nutritional status: subjective global assessment
Time Frame
24-72 hours after hospital admission
Title
Medical-nutritional status
Description
Medical-nutritional status: nutritional risk index
Time Frame
24-72 hours after hospital admission
Title
biochemical markers
Description
Changes in nutritional status biochemical markers: albumin in serum
Time Frame
every week until a maximum follow-up at 30 days
Title
biochemical markers
Description
Changes in nutritional status biochemical markers: lymphocytes in serum.
Time Frame
every week until a maximum follow-up at 30 days
Title
biochemical markers
Description
Changes in nutritional status biochemical markers: prealbumin in serum.
Time Frame
every week until a maximum follow-up at 30 days
Title
biochemical markers
Description
Changes in nutritional status biochemical markers: transferrin in serum.
Time Frame
every week until a maximum follow-up at 30 days
Title
Metabolic profile
Description
Changes in metabolic profile in serum glucose concentration
Time Frame
every week until a maximum follow-up at 30 days
Title
Metabolic profile
Description
Changes in metabolic profile in serum tests liver
Time Frame
every 15 days up to a maximum follow-up at 30 days
Title
Length of hospital stay of patients
Description
Determine the length of hospital stay of patients.
Time Frame
follow-up at 30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Women and men >18 years and <70 years old. Diagnosis of high-output enterocutaneous fistula for the first time Need for parenteral nutrition Exclusion Criteria: Octreotide use Palliative care Steroid use Oxalate nephropathy G6PD deficiency Hemochromatosis Abdominal surgeries in the last 6 months Hospitalizations for more than 15 days in the last 6 months
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Elizabeth Pérez Cruz
Phone
525557477560
Ext
7497
Email
pece_liz@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Salvador Ortiz Gutiérrez
Phone
525557477560
Ext
7497
Email
sortizgtz@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elizabeth Pérez Cruz
Organizational Affiliation
Hospital Juarez de Mexico
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Juárez de México
City
Ciudad de México
State/Province
Cdmx
ZIP/Postal Code
07760
Country
Mexico
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Elizabeth PEREZ-CRUZ, MD
Phone
5557477560
Ext
7497
Email
pece_liz@yahoo.com.mx

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
19874952
Citation
Jeejeebhoy K. Zinc: an essential trace element for parenteral nutrition. Gastroenterology. 2009 Nov;137(5 Suppl):S7-12. doi: 10.1053/j.gastro.2009.08.014.
Results Reference
background
PubMed Identifier
32404636
Citation
Yanase F, Fujii T, Naorungroj T, Belletti A, Luethi N, Carr AC, Young PJ, Bellomo R. Harm of IV High-Dose Vitamin C Therapy in Adult Patients: A Scoping Review. Crit Care Med. 2020 Jul;48(7):e620-e628. doi: 10.1097/CCM.0000000000004396.
Results Reference
background
PubMed Identifier
33368576
Citation
Couper C, Doriot A, Siddiqui MTR, Steiger E. Nutrition Management of the High-Output Fistulae. Nutr Clin Pract. 2021 Apr;36(2):282-296. doi: 10.1002/ncp.10608. Epub 2020 Dec 24.
Results Reference
background
PubMed Identifier
28385477
Citation
Weimann A, Braga M, Carli F, Higashiguchi T, Hubner M, Klek S, Laviano A, Ljungqvist O, Lobo DN, Martindale R, Waitzberg DL, Bischoff SC, Singer P. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017 Jun;36(3):623-650. doi: 10.1016/j.clnu.2017.02.013. Epub 2017 Mar 7.
Results Reference
background
PubMed Identifier
25455960
Citation
Girard E, Messager M, Sauvanet A, Benoist S, Piessen G, Mabrut JY, Mariette C. Anastomotic leakage after gastrointestinal surgery: diagnosis and management. J Visc Surg. 2014 Dec;151(6):441-50. doi: 10.1016/j.jviscsurg.2014.10.004. Epub 2014 Oct 22.
Results Reference
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Vitamin C and Zinc in Patients With Enterocutaneous Fistulas.

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