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Nitric Oxide. 2020 Jan 1;94:63-68. doi: 10.1016/j.niox.2019.10.009. Epub 2019 Oct 25.

A randomized pilot study of nitrate supplementation with beetroot juice in acute respiratory failure.

Author information

1
Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA; Critical Illness Injury and Recovery Research Center, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA. Electronic address: clark.files@wakehealth.edu.
2
Department of Health & Exercise Science, Wake Forest University: Winston-Salem, NC, 27109, USA.
3
Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA; Critical Illness Injury and Recovery Research Center, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
4
Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
5
Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kentucky, Lexington, USA.

Abstract

Nitrate rich beetroot juice (BRJ) can enhance nitric oxide signaling, leading to improved physical function in healthy and diseased populations, but its safety and biologic efficacy have not been evaluated in a critically ill population. We randomized 22 previously functional acute respiratory failure patients to either BRJ or placebo daily until day 14 or discharge. We measured blood nitrate and nitrite levels and quantified strength and physical function at intensive care unit (ICU) and hospital discharge. Participants were predominantly male (54%), aged 68.5 years with an APACHE III score of 62. BRJ increased plasma nitrate (mean 219.2 μM increase, p = 0.002) and nitrite levels (mean 0.144 μM increase, p = 0.02). We identified no adverse events. The unadjusted and adjusted effect sizes of the intervention on the short physical performance battery were small (d = 0.12 and d = 0.17, respectively). In this pilot trial, administration of BRJ was feasible and safe, increased blood nitrate and nitrate levels, but had a small effect on physical function. Future studies could evaluate the clinical efficacy of BRJ as a therapy to improve physical function in survivors of critical illness.

KEYWORDS:

Critical illness; Intensive care unit acquired weakness; Muscle wasting; Nitric oxide; Physical function

PMID:
31669503
DOI:
10.1016/j.niox.2019.10.009

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