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High Protein Diet + Exercise for Muscle Loss (PROXIMUS Trial)
Boston, MA
N/A
Recruiting
Led By Nilesh Mehta, MD
Research Sponsored by Boston Children's Hospital
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial Must have
PICU patients aged 1 year (corrected) to <18 years
Require mechanical ventilation (endotracheal intubation or tracheostomy) in the first 48 hours of PICU admission, and are expected to remain intubated for ≥48 hours
Must not have
Kidney failure (≥KDIGO Stage 3) without replacement therapy
Inborn errors of metabolism
Timeline
Screening 3 weeks
Treatment Varies
Follow Up 6 months
Awards & highlights
No Placebo-Only Group
Summary
This trial is testing whether a high protein diet and individualized exercise plan can help preserve muscle mass and improve function in children during the acute phase of critical illness.
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Who is the study for?
This trial is for children aged 1 to under 18 years who are on mechanical ventilation within the first 48 hours of PICU admission and expected to stay on it. They must be able to consent within this period. It's not for those with liver failure, certain medical conditions requiring bedrest, high-risk burns, severe kidney issues without therapy, or incompatible diets.Check my eligibility
What is being tested?
The PROXIMUS study tests if giving high protein with tailored exercise during critical illness helps maintain muscle mass and improve mobility in kids after treatment. Participants will either receive this new approach or standard care, decided randomly at two centers.See study design
What are the potential side effects?
Potential side effects may include digestive discomfort due to high protein intake and physical strain from exercise routines. However, the main focus is on feasibility and safety so close monitoring will occur.
Eligibility Criteria
Inclusion Criteria
You may be eligible if you check “Yes” for the criteria belowSelect...
I am between 1 and 17 years old, corrected for prematurity.
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I needed a breathing tube within the first 48 hours of ICU admission and will need it for at least 2 more days.
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Exclusion Criteria
You may be eligible for the trial if you check “No” for criteria below:Select...
My kidney function is severely reduced and I am not on dialysis.
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I have a genetic disorder that affects my metabolism.
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I have severe burns covering a large part of my body.
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I am receiving or have received ECMO therapy.
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I am experiencing severe liver failure.
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I need to be in bed or have muscle relaxants for medical reasons.
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My child was fairly active when admitted to the PICU.
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I cannot receive standard nutrition support or follow the study's diet.
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Timeline
Screening ~ 3 weeks3 visits
Treatment ~ Varies
Follow Up ~ 6 months
Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~6 months
Treatment Details
Study Objectives
Study objectives can provide a clearer picture of what you can expect from a treatment.Primary study objectives
Feasibility of recruitment and adherence to study procedures
Safety of protein (new renal injury) and exercise interventions (any associated adverse events)
Tolerability of protein intervention (serum creatinine change)
Secondary study objectives
Assessment of Functional status - sensory, communication, motor, sensory and feeding
Change in Muscle mass thickness
Functional assessment - motor, cognitive and responsibility
+1 moreOther study objectives
Protein catabolism (breakdown)
Awards & Highlights
No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.
Trial Design
2Treatment groups
Experimental Treatment
Active Control
Group I: High protein plus exerciseExperimental Treatment1 Intervention
High protein nutrition: To achieve the prescribed age-appropriate high protein target, dietitians will use EN preferentially, or if EN is contraindicated, PN may be used. High-protein EN formulas and/or protein supplements (powder or liquid) will be added to formula/breast milk feedings or administered separately in divided bolus doses. Dietitians routinely employ and customize these solutions in their scope of practice. When EN is insufficient to meet protein targets, PN may be prescribed to make up the deficit on or after the end of PICU day 3. Energy and protein delivery adequacy (% of prescribed goal) will be monitored daily by the study team.
Patients in this arm will also be prescribed the age-appropriate highest-level of mobility by the rehabilitation team with a goal of 30 minutes duration, twice daily.
Group II: Standard protein and exerciseActive Control1 Intervention
All enrolled patients randomized to this arm will receive a baseline nutrition and nurse-driven mobility pathway and other evidence-based bundled strategies as standard of care.
Find a Location
Closest Location:Johns Hopkins Hospital· Baltimore, MD· 344 miles
Who is running the clinical trial?
Boston Children's HospitalLead Sponsor
795 Previous Clinical Trials
5,583,612 Total Patients Enrolled
Johns Hopkins UniversityOTHER
2,361 Previous Clinical Trials
15,160,410 Total Patients Enrolled
Nilesh Mehta, MDPrincipal InvestigatorFaculty, Boston Children's Hospital
Sapna R Kudchadkar, MD, PhDPrincipal InvestigatorFaculty, Johns Hopkins
1 Previous Clinical Trials
2,500 Total Patients Enrolled
Media Library
Eligibility Criteria:
This trial includes the following eligibility criteria:- My kidney function is severely reduced and I am not on dialysis.I am between 1 and 17 years old, corrected for prematurity.I needed a breathing tube within the first 48 hours of ICU admission and will need it for at least 2 more days.I have a genetic disorder that affects my metabolism.I have severe burns covering a large part of my body.I am receiving or have received ECMO therapy.You are at a high risk of developing refeeding syndrome.I am experiencing severe liver failure.I need to be in bed or have muscle relaxants for medical reasons.My child was fairly active when admitted to the PICU.You are in the final stages of your life or have decided to change the focus of your medical care towards comfort rather than treatment.I cannot receive standard nutrition support or follow the study's diet.
Research Study Groups:
This trial has the following groups:- Group 1: Standard protein and exercise
- Group 2: High protein plus exercise
Awards:
This trial has 1 awards, including:- No Placebo-Only Group - All patients enrolled in this study will receive some form of active treatment.
Timeline:
This trial has the following timeline:- Screening: It may take up to 3 Weeks to process to see if you qualify in this trial.
- Treatment: The duration you will receive the treatment varies.
- Follow Ups: You may be asked to continue sharing information regarding the trial for 6 Months after you stop receiving the treatment.