Evidence map›Paper›PMID 31511044›Full record

Trial reportTrials2019

Leucine-enriched essential amino acid supplementation in mechanically ventilated trauma patients: a feasibility study.

L Wandrag, S J Brett, G S Frost, M To, E Alves Loubo, N C Jackson, A M Umpleby, V Bountziouka, M Hickson

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

L WandragNutrition and Dietetic Research Group, Department of Investigative Medicine, Imperial College London, London, UK. l.wandrag@imperial.ac.uk.ORCID http://orcid.org/0000-0003-4577-8775
S J BrettCentre for Peri-operative Medicine and Critical Care Research, Imperial College Healthcare NHS Trust, London, UK.
G S FrostNutrition and Dietetic Research Group, Department of Investigative Medicine, Imperial College London, London, UK.
M ToNutrition and Dietetic Research Group, Department of Investigative Medicine, Imperial College London, London, UK.
E Alves LouboNutrition and Dietetic Research Group, Department of Investigative Medicine, Imperial College London, London, UK.
N C JacksonDepartment of Nutritional Science, University of Surrey, Guildford, UK.
A M UmplebyDepartment of Nutritional Science, University of Surrey, Guildford, UK.
V BountzioukaStatistical Support Service, Population, Policy and Practice Programme, Institute of Child Health, University College London, London, UK.
M HicksonNutrition and Dietetic Research Group, Department of Investigative Medicine, Imperial College London, London, UK.
Imperial College London · GBUniversity of Surrey · GBGuy's and St Thomas' NHS Foundation Trust · GBImperial College Healthcare NHS Trust · GBRoyal Statistical Society · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCritically 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.

methodsA 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.

resultsEight 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.

conclusionL-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.

trial registrationISRCTN Registry, ISRCTN79066838 . Registered on 25 July 2012.

Indexed as

Dietary SupplementsRespiration, ArtificialAdultAgedAged, 80 and overAmino Acids, EssentialCritical IllnessFeasibility StudiesFemaleHumansIntensive Care UnitsLeucineMaleMiddle AgedOutcome Assessment, Health CareProspective StudiesAmino Acids, EssentialLeucineCritically illEssential amino acidsLeucineMechanical ventilationMuscle ultrasoundMuscle wastingNitrogen balanceProtein turnoverTrauma

Identifiers

PMID31511044
PMCPMC6737604
OpenAlexW2972355851

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.