Using sodium acetate instead of sodium chloride in nutrition for preterm babies to prevent metabolic acidosis

Prevention of Metabolic Acidosis in Preterm Neonates by Replacing Sodium Chloride With Sodium Acetate in Parenteral Nutrition - A Randomized Controlled Trial. (PROTECT Trial)

Phase 3 Interventional Aga Khan University Hospital, Pakistan · NCT06545565

This study is testing if using sodium acetate instead of sodium chloride in nutrition can help prevent and treat metabolic acidosis in preterm babies.

Quick facts

PhasePhase 3
Study typeInterventional
Enrollment200 (estimated)
Ages1 Day to 3 Days
SexAll
SponsorAga Khan University Hospital, Pakistan Academic / other
Locations1 site (Karachi, Sindh)
Trial IDNCT06545565 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to determine whether the addition of sodium acetate to parenteral nutrition (PN) can effectively prevent and treat metabolic acidosis in preterm neonates. The study will compare the incidence of metabolic acidosis and associated comorbidities in infants receiving sodium acetate versus those receiving the standard sodium chloride in PN. Additionally, it seeks to establish optimal dosing guidelines for sodium acetate in this vulnerable population. The trial will be conducted at Aga Khan University Hospital, focusing on neonates with a gestational age of less than 33 weeks.

Who should consider this trial

Good fit: Ideal candidates for this study are preterm neonates admitted to the NICU with a gestational age of less than 33 weeks who require parenteral nutrition.

Not a fit: Patients with inborn errors of metabolism, severe congenital conditions, or severe metabolic alkalosis will not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly reduce the incidence of metabolic acidosis and improve health outcomes for preterm neonates.

How similar studies have performed: While the use of sodium acetate in PN is a novel approach at this institution, similar studies have shown promising results in other settings.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. Written informed consent obtained by parents/legal representative (according to local regulations) before the initiation of PN.
2. All the neonates who were admitted to the NICU of AKUH and received PN during 28 days of their life.
3. Gestational age \< 33 weeks

Exclusion Criteria:

1. Infants with an inborn error of metabolism
2. Genetic or congenital condition that affects neurodevelopment or requires multiple surgeries (e.g., congenital viral infection, hydrops, complex congenital heart disease, severe dysmorphic features, etc.)
3. Severe metabolic alkalosis, in critically ill neonates, is defined as a persistent elevation of the serum pH above 7.45 and it also involves a primary increase in serum bicarbonate (HCO3-) concentration \> 25mEq/L.
4. Severe Hypernatremia, in critically ill neonates, is defined as persistently high serum sodium levels \> 150 mmol/L
5. Severe liver failure and syndromic infants with multiple congenital abnormalities and severe perinatal asphyxia

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Where this trial is running

Karachi, Sindh

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Metabolic AcidosisNeonatal DiseaseNeonatal Complicationmetabolic acidosissodium acetateneonatesParenteral Nutrition
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.