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Assessment of the Safety and efficacy of an amino acid blend on muscle and gut functionality in Intensive Care Unit (ICU) patients.
Since this was a proof of concept, exploratory trial, we assessed different primary outcomes without hierarchy.
This monocentric trial was a parallel, randomized, double-blind, controlled study. Patients hospitalized in the ICU for sepsis or ARDS were enrolled.
The treatment group (n=15) was administered the study product (amino acid blend) and the negative control group (=15) was administrated maltodextrin only. The mode of administration was nasogastric probe.
The treatment period was 21 days. Subject were followed during stay in High care and intermediate care units up to 2 months or after hospital discharge with a follow up until 12 months.
Recruitment stopped when 30 patients (15 in each group) reached V4.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Active group | Active Comparator | Blend of amino acids |
|
| Placebo group | Placebo Comparator | maltodextrin only |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Blend of amino acids | Dietary Supplement | The product was poured in bottles containing the enteral nutrition that the patient received as standard of care. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety: Renal function change | Renal function will be daily assessed from urine output, serum creatinin and glomerular filtration rate | 60 days from the beginning of the intervention |
| Efficacy: muscle functionality change | i. Muscle (quadriceps) extension isometric strength in response to magnetic stimulation; diaphragm muscle strength in response to magnetic stimulation. Forced vital capacity and maximal inspiratory and expiratory pressures will systematically be recorded. ii. Loss in quadriceps muscle mass and metabolism will be measured by Magnetic resonance imaging. Muscle protein catabolism will be evaluated from measures of 3-methyl histidine in the 24-h urine (reported to urine creatinine). | 12 months from the beginning of the intervention (timepoints: D1, D7, D14, D21, D60, D180, D365) |
| Efficacy: gut barrier structure and functionality improvement | i. Enterocytes damage by measurement of I-FABP (intestinal fatty acid-binding protein) in plasma and urine. ii. Functional enterocyte mass by citrulline plasma concentration. iii. Gut barrier function by the translocation of bacteria based on plasma D-Lactate concentration | 12 months from the beginning of the intervention (timepoints: D1, D7, D14, D21, D60, D180, D365) |
| Efficacy: inflammatory status change | i. Calprotectin in feces, which is secreted by the neutrophils of the gut mucosae and is released in the gut when the mucosa is inflamed. ii. Acute phase protein concentration in plasma (CRP, fibrinogen, ferritin, prealbumin) | 12 months from the beginning of the intervention (timepoints: D1, D7, D14, D21, D60, D180, D365) |
| Efficacy: general recovery improvement | i. Length of stay (LOS) in High care and intermediate care units. ii. Time (days) free of ventilation until discharge high care. iii. Time (days) to recover on walking with or without aid |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Djillali Annane, Pr | Raymond Poincaré Hospital, Garches, France | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hôpital Raymond Poincaré (AP-HP) | Garches | 92380 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36397118 | Derived | Heming N, Carlier R, Prigent H, Mekki A, Jousset C, Lofaso F, Ambrosi X, Bounab R, Maxime V, Mansart A, Crenn P, Moine P, Foltzer F, Cuenoud B, Konz T, Corthesy J, Beaumont M, Hartweg M, Roessle C, Preiser JC, Breuille D, Annane D. Effect of an enteral amino acid blend on muscle and gut functionality in critically ill patients: a proof-of-concept randomized controlled trial. Crit Care. 2022 Nov 17;26(1):358. doi: 10.1186/s13054-022-04232-5. |
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| Maltodextrin only | Dietary Supplement | The product was poured in bottles containing the enteral nutrition that the patient received as standard of care. |
|
| 12 months from the beginning of the intervention (timepoints: D1, D7, D14, D21, D60, D180, D365) |
| Nutrient profiling | Nutrient profiling will be assessed from blood metabolomics analyses | Over 60 days from the beginning of intervention (timepoints: D1, D7, D14, D21, D60) |