Grant: Project Grant

Critically-ill patients admitted to the intensive care unit undergo inflammation and tissue damage, which contribute to ongoing organ malfunction. Studies indicate that increased dietary protein, or protein building blocks (amino acids), may improve their health outcomes. In agreement, studies in clinical and laboratory research studies indicate that the administration of amino acids can prevent protein breakdown. Controversy arises, however, from a number of clinical trials that failed to show an overall benefit for early nutrition in the critically-ill. This may be because the trials did not focus on protein therapy, nor did they use biological measurements to discriminate between patients who responded to nutritional therapy and those who did not. Here, we propose that the intravenous supplementation of amino acids in critically-ill patients can improve protein metabolism, and that this is associated with biological signatures ('biomarkers') that identify the patients who will most likely benefit. Our team is in a unique position to measure protein metabolism and biomarkers using state-of-the-art technologies that can be translated to clinical practice. The discovery and development of biomarkers of nutritional response is a critical step towards a larger clinical trial to establish protein nutrition as an effective therapy in the critically-ill.