Wandrag, L;
Brett, SJ;
Frost, GS;
To, M;
Loubo, EA;
Jackson, NC;
Umpleby, AM;
... Hickson, M; + view all
(2019)
Leucine-enriched essential amino acid supplementation in mechanically ventilated trauma patients: a feasibility study.
Trials
, 20
(1)
, Article 561. 10.1186/s13063-019-3639-2.
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Abstract
Background Critically ill patients lose up to 2% of muscle mass per day. We assessed the feasibility of administering a leucine-enriched essential amino acid (L-EAA) supplement to mechanically ventilated trauma patients with the aim of assessing the effect on skeletal muscle mass and function. Methods A randomised feasibility study was performed over six months in intensive care (ICU). Patients received 5 g L-EAA five times per day in addition to standard feed (L-EAA group) or standard feed only (control group) for up to 14 days. C-reactive protein, albumin, IL-6, IL-10, urinary 3-MH, nitrogen balance, protein turnover ([1-13C] leucine infusion), muscle depth change (ultrasound), functional change (Katz and Barthel indices) and muscle strength Medical Research Council (MRC) sum score to assess ICU Acquired Weakness were measured sequentially. Results Eight patients (9.5% of screened patients) were recruited over six months. L-EAA doses were provided on 91/124 (73%) occasions. Inflammatory and urinary marker data were collected; serial muscle depth measurements were lacking due to short length of stay. Protein turnover studies were performed on five occasions. MRC sum score could not be performed as patients were not able to respond to the screening questions. The Katz and Barthel indices did not change. L-EAA delivery was achievable, but meaningful functional and muscle mass outcome measures require careful consideration in the design of a future randomised controlled trial. Conclusion L-EAA was practical to provide, but we found significant barriers to recruitment and measurement of the chosen outcomes which would need to be addressed in the design of a future, large randomised controlled trial.
| Type: | Article |
|---|---|
| Title: | Leucine-enriched essential amino acid supplementation in mechanically ventilated trauma patients: a feasibility study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s13063-019-3639-2 |
| Publisher version: | https://doi.org/10.1186/s13063-019-3639-2 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Medicine, Research & Experimental, Research & Experimental Medicine, Muscle wasting, Essential amino acids, Leucine, Muscle ultrasound, Critically ill, Nitrogen balance, Protein turnover, Mechanical ventilation, Trauma, PROTEIN ANABOLISM, CRITICAL ILLNESS, MUSCLE MASS, STRENGTH |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10084677 |
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