This Nutrient Helps Critically Ill Patients on Ventilation

For critically ill patients on ventilation in ICU, this simple supplement could make all the difference.

Citrulline is a still little discussed amino acid that deserves to be discussed more. Citrulline’s major contribution is that it is converted into arginine. Arginine is converted in nitric oxide, and nitric oxide dilates your blood vessels and improves blood flow. But here’s the important part: supplementing citrulline has been shown to be more effective than supplementing arginine for increasing nitric oxide.

For critically ill patients in ICU, proper nutrition is critical. After trauma or surgery, citrulline levels drop in critically ill patients, that leads to increases in cytokines and inflammation. That leads to more severe disease and critical illness. In patients with sepsis and acute respiratory distress syndrome, citrulline levels are extremely low. And low levels of citrulline are associated with poor prognosis.

So, a new double-blind study put citrulline to the test on critically ill patients who were on ventilation in intensive care units.

Supplementing citrulline made a big difference. It significantly reduced fasting blood sugar, total cholesterol, harmful LDL cholesterol. It also significantly reduced high-sensitivity CRP, a marker of inflammation.

Importantly, taking citrulline significantly reduced the time needed on ventilation as well as the SOFA score, which measures organ failure. Higher SOFA scores indicate a higher chance of death. Days alive and days free of ventilation were significantly better on citrulline during the study. There were 8 deaths in the control group but only 2 in the citrulline group: a 14.05% reduced risk of death.

The citrulline was safe: there were no adverse side effects.

This study shows why citrulline should be getting more attention. For critically ill patients in ICU, it “may increase the probability of survival without mechanical ventilation.”

Arch Acad Emerg Med. 2023;11(1):e11

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