Muscle wasting, which hinders recovery, is a hallmark of a serious disease that drags on for an extended period of time. Taking an amino acid supplement may help prevent muscle loss, speed up intestinal mucosa regeneration, and fortify the body’s natural defenses in the digestive tract. All patients with sepsis or acute respiratory distress syndrome were enrolled in this single-center, randomized, double-blind, placebo-controlled study. Patients were given either a specific mixture of five amino acids or a placebo with their enteral meal for 21 days. At baseline and 1, 2, 3, and 8 weeks following randomization, biomarkers of renal function, gut barrier structure, and functional capacity were obtained. The volume of the anterior quadriceps was measured using magnetic resonance imaging (MRI), and twitch airway pressure was used to evaluate muscle structure and function. Information was compared between the groups concerning the initial sample.

About 35 patients in critical condition were assigned at random. Due to the amino acid mixture, there was no reduction in creatinine clearance, creatinine levels in the blood, or urine production. The amino acid group saw a statistically significant increase in plasma citrulline levels over the course of treatment (mean difference [95% CI] 5.86 [1.72; 10.00] nmol/mL P=0.007). At 1 week, the ratio of means for alanine aminotransferase (0.5 [0.29; 0.86] (P=0.015) and alkaline phosphatase (0.73 [0.57; 0.94] (P=0.015)) was lower in the amino acid group than in the placebo group. 

About 3 weeks following randomization, the amino acid group had higher airway pressure and anterior quadriceps volume during twitches compared to the placebo group (difference in means of 10.6 [0.99; 20.20] cmH20 (P=0.035) and 3.12 [0.5; 5.73] cm3/kg (P=0.022)). Twitch airway pressure and anterior quadriceps volume were enhanced by amino acid supplementation, while plasma citrulline levels were lowered and alanine aminotransferase levels were raised.