Amino Acid Nutrition in the Critically-ill (AA-ICU)
Critical Illness, Inflammation, Malnutrition
About this trial
This is an interventional prevention trial for Critical Illness focused on measuring Amino acids, critically-ill, catabolic, nutrition, anabolic
Eligibility Criteria
Inclusion Criteria:
- Mechanically ventilated adult patients (>18 years old) admitted to ICU with an expected ICU dependency (alive and need for mechanical ventilation
- Vasopressor therapy, or mechanical circulatory support) at the point of screening of an additional 3 days, as estimated by the treating physician.
Exclusion Criteria:
- Patients who are moribund (expected death within 48 hours)
- Expected to have life-sustaining treatments withdrawn in the next 3 days
- Those with a contraindication to enteral nutrition (EN)
- Already on parenteral nutrition (PN)
- Those with acute fulminant hepatitis or severe chronic liver disease (Child's class C)
- Patients on extracorporeal membrane oxygenation or carbon dioxide removal* Patients with organ transplantation
- Those with a broncho-pleural fistula
- Patients with documented allergies to any of the study nutrients or its excipients will be excluded.
- Patients requiring continuous renal replacement therapy or extracorporeal membrane oxygenation are excluded due to inability to accurately measure protein turnover.
Sites / Locations
- McGill University health CentreRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
Active Comparator
Group 1: Peptamen 1.5% via enteral only
Group 2: Prosol 20% IV to 1.75g/kg/day
Group 3: Prosol 20% IV to 2.5g/kg/day
Study patients in this group will be prescribed 1.0 g/kg/d of protein using standard EN Peptamen 1.5%. Based on current compliance or tolerance statistics, investigators expect patients to only receive 50-60% of these prescribed doses; effective protein intake will therefore be approximately 0.5-0.6 g/kg/d
Patients in group 2 will receive the same enteral feeding as group 1 (Peptamen 1.5) but in addition will receive sufficient intravenous amino acid supplements (Prosol 20%) to achieve an effective fixed dose of 1.75 g/kg/d
Patients in this group will receive intravenous amino acids (Prosol 20%) in addition to standard enteral Peptamen 1.5% to achieve an effective protein intake of 2.5 g/kg/day.