Circadian cycles, metabolism, and nutrition are intimately linked, and the timing of meals play an important role in synchronizing peripheral circadian rhythms. There are little data describing the influence of nocturnal feeds on sleep, metabolism, and overall health in hospitalized children. To evaluate this association, the investigators will conduct a single-center, randomized, non-blinded controlled trial that will test the impact of nocturnal enteral/parenteral nutrition on patient outcomes.
HSCT provides a potential cure for children and adults with high risk and relapsed malignancy, immune deficiency, and other fatal illnesses. Circadian cycles, metabolism, and nutrition are intimately linked, and the timing of meals play an important role in synchronizing peripheral circadian rhythms; however, the standard of care for HSCT recipients is to deliver continuous feeds (either enterally or parenterally). The objective of this study is to evaluate the influence of the timing of feeding on sleep and metabolism in HSCT subjects. The investigators hypothesize patients receiving feeds during daytime hours (0800-2000) in comparison to continuous (24 hours), will have improved sleep efficiency, decreased blood glucose, insulin, and triglycerides over patients who receive feeding overnight. The aim of this study is to evaluate the influence of the timing of feeds on sleep, metabolism, and outcomes in HSCT subjects.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
21
Cases will receive their nutrition over a period of 12-16 hours, with minimum 8 hours of fasting and maximum 12 hours of fasting. Feeding will begin in morning hours unless otherwise directed by an investigator or registered dietician.
Cincinnati Children's Hospital
Cincinnati, Ohio, United States
Number of wake episodes
Number of wake episodes
Time frame: 21 days
Duration of wake episodes
Duration of wake episodes
Time frame: 21 days
Hypertension
Incidence of hypertension
Time frame: 21 days
Weight change
Change in weight at day +7, +14, and +21 from day 0
Time frame: 21 days
Time to tolerating oral feeds
Number of days post-transplant until the patient tolerates feeds/nutrition
Time frame: 21 days
Neutrophil engraftment
Time to absolute neutrophil count \>500
Time frame: 21 days
Cortisol levels
3 times weekly morning cortisol levels
Time frame: 21 days
Triglyceride levels
Weekly triglyceride levels
Time frame: 21 days
Glucose levels
Daily glucose levels
Time frame: 21 days
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