Increasing Fluids in Older Adults to Prevent & Treat Pressure Ulcers

This study has been completed.
Sponsor:
Information provided by:
University of California, San Francisco
ClinicalTrials.gov Identifier:
NCT00507650
First received: July 24, 2007
Last updated: July 25, 2007
Last verified: July 2007

July 24, 2007
July 25, 2007
September 2003
Not Provided
Collagen deposition [ Time Frame: 10 days ]
Same as current
Complete list of historical versions of study NCT00507650 on ClinicalTrials.gov Archive Site
  • Total body water [ Time Frame: 10 days ]
  • Safety - development of heart failure [ Time Frame: Study duration ]
Same as current
Not Provided
Not Provided
 
Increasing Fluids in Older Adults to Prevent & Treat Pressure Ulcers
Supplement Fluid & Collagen Deposition

The purpose of this study is to determine whether providing extra fluid to nursing home residents will help prevent or heal pressure ulcers. We hypothesize that providing extra fluid to nursing home residents will increase their skin blood flow and oxygen to support healing and maintaining healthy skin. Participants are enrolled who have a pressure ulcer or who are at-risk for an ulcer (determined by looking at risk factors). The study is divided into two 10 day phases. In Phase 1, we examine participant's usual status, including fluid intake and baseline healing potential. In Phase 2, participants are randomly placed in groups to receive either their usually prescribed fluid intake or additional fluid. A study nurse provides the fluid to the residents. We measure their actual intake, their body water, how well their kidneys are working, their potential to heal, and also monitor them for the development of fluid overload. This study is important because it helps us understand the role of a basic nursing intervention in the prevention and treatment of pressure ulcers.

Pressure ulcers are prevalent in nursing homes. They heal slowly, cause pain, impair quality of life, and are expensive to treat. Dehydration is a problem in some nursing home residents and under-perfusion a problem in others. Theoretically, providing supplemental fluid to under-hydrated residents should increase fluid in the various fluid compartments of the body, increase subcutaneous oxygen, support skin integrity, enhance pressure ulcer blood flow and pressure ulcer healing, including collagen production. This proposition has not been examined in nursing home residents with pressure ulcers.

The purpose of this randomized clinical trial (RCT) in which subjects serve as their own control is to determine whether administration of supplemental fluid to nursing home residents with or at risk for pressure ulcers enhances collagen deposition. Specifically, this study will determine whether oral administration of supplemental fluid given daily for five days to persons with or at risk for pressure ulcers enhances collagen deposition, increases total body water, augments subcutaneous tissue oxygen, increases pressure ulcer oxygenation, and is safe.

The sample will be nursing home residents at risk for or with pressure ulcers. After consent, baseline measures of collagen deposition, pressure ulcer oxygen, fluid intake, and body water in the various fluid compartments are measured. Expanded polytetrafluoroethylene (ePTFE) tubes are used to measure collagen deposition. Bioelectrical impedance is used to measure body water. In the treatment phase, subjects are randomized to one of the two supplemental fluid regimes. Supplemental fluid is administered for five days and collagen deposition, subcutaneous tissue oxygen, pressure ulcer oxygen, and body water in the various compartments again measured. Subjects are monitored for fluid overload. Data are analyzed with RMANOVA and logistic regression techniques.

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Single Blind
Primary Purpose: Treatment
Pressure Ulcers
  • Dietary Supplement: Fluid intervention
    Volume of fluid prescribed by physician or provider/day X 5 days.
  • Dietary Supplement: Fluid intervention
    Fluid volume and type prescribed by physician or provider plus 10 ml/kg/day X 5 days.
  • Active Comparator: PRESCRIBED
    Fluid volume and type prescribed by MD or provider.
    Intervention: Dietary Supplement: Fluid intervention
  • Experimental: SUPPLEMENTAL
    Fluid volume and type prescribed by physician or provider plus 10 ml/kg X 5 days.
    Intervention: Dietary Supplement: Fluid intervention
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
63
March 2007
Not Provided

Inclusion Criteria:

  • Persons age =/> 60 years at risk for pressure ulcers (Braden Scale score <18 or nonblanchable erythema [Stage 1 ulcer]) or with a Stage II-IV pressure ulcer and WBC of at least 2,000/mm3

Exclusion Criteria:

Those:

  • Who have or have had heart failure or renal failure/insufficiency
  • Who currently smoke
  • With acute illness or having experienced it in the last 7 days
  • Taking immunosuppressive drugs
  • With an implantable defibrillator
  • With a glycosylated hemoglobin of >8%
  • With a body mass index is <21 kg/m2 or > 30 kg/m2; and
  • Being treated for dehydration.
Both
60 Years and older
No
Contact information is only displayed when the study is recruiting subjects
Not Provided
 
NCT00507650
NR0008241
Yes
Not Provided
University of California, San Francisco
Not Provided
Principal Investigator: Nancy A. Stotts, RN, EdD University of California, San Francisco
University of California, San Francisco
July 2007

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP