• C Jones, J Eddleston, A McCairn, S Dowling, D McWilliams, E Coughlan, and R D Griffiths.
• Critical Care, Ward 4E, Whiston Hospital, Prescot, UK; Musculoskeletal Biology, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK. Electronic address: christinajonesc@aol.com.
• J Crit Care. 2015 Oct 1; 30 (5): 901-7.

PurposePatients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery.Materials And MethodsIntensive care patients aged 45 years or older, with a combined intensive care unit stay/pre-intensive care unit stay of 5 days or more were recruited to a randomized controlled trial examining the effect of PEPSE and GEAA on recovery. The 2 factors were tested in a 2 × 2 factorial design: (1) GEAA drink twice daily for 3 months and (2) 6-week PEPSE in first 3 months. Primary efficacy outcome was an improvement in the 6-minute walking test at 3 months.ResultsA total of 93 patients were randomized to the study. Patients receiving the PEPSE and GEA had the biggest gains in distance walked in 6-minute walking test (P < .0001). There were also significant reductions in rates of anxiety in study groups control supplement/PEPSE (P = .047) and GEAA supplement/PEPSE (P = .036) and for GEAA supplement/PEPSE in depression (P = .0009).ConclusionEnhanced rehabilitation combined with GEAA supplement may enhance physical recovery and reduce anxiety and depression.Copyright © 2015 Elsevier Inc. All rights reserved.

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