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Pr)25.1(ot)15.1(ein is no e)30(x)35.2(c)15.1(eption.)]TJ ET EMC /P <>BDC BT 4.75 0 0 4.75 374.806 540.9441 Tm (1, 2)Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 382.1332 537.1316 Tm [( Pr)25.2(ot)15.1(ein ca)5.1(tabolism is incr)25.2(eased as)]TJ ET EMC /P <>BDC BT 9.5 0 0 9.5 546.8199 537.1316 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 550.5021 537.1316 Tm ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 554.1844 537.1316 Tm ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 557.8666 537.1316 Tm ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 561.5487 537.1316 Tm ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 565.231 537.1316 Tm ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 56.2021 522.1316 Tm .0987 Tw [(a c)15.1(onsequenc)15.1(e of critical illnes)10(s, which leads t)15.1(o)0( r)25.1(apid and se)25.2(v)30(e)0(r)25.2(e)0( sk)25.1(eletal muscle w)20(a)0(s)10(ting.)]TJ ET EMC /P <>BDC BT 4.75 0 0 4.75 482.5865 525.9441 Tm 0 Tw (3)Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 485.4839 522.1316 Tm .0987 Tw [( T)20(his sk)25.1(eletal)]TJ ET EMC /P <>BDC BT 9.5 0 0 9.5 546.819 522.1316 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 56.2021 507.1316 Tm .0196 Tw [(muscle w)20(a)0(s)10(ting is, in turn, as)10(socia)5.1(t)15.1(ed with int)15.1(ensiv)30(e car)25.1(e unit \(ICU\)-ac)10(quir)25.1(ed w)25.2(eaknes)10(s.)]TJ ET EMC /P <>BDC BT 4.75 0 0 4.75 463.0211 510.9441 Tm (4, 5)Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 471.6597 507.1316 Tm [( F)15.1(or this r)25.2(eason,)]TJ ET EMC /P <>BDC BT 9.5 0 0 9.5 546.82 507.1316 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 56.2021 492.1316 Tm .2253 Tw [(ther)25.1(e is widespr)25.1(ead ac)15.1(c)15.1(eptanc)15.1(e tha)5.1(t pr)25.1(ot)15.1(ein tar)25.2(gets should be higher in the critically ill than in the)]TJ ET EMC /P <>BDC BT 9.5 0 0 9.5 546.8195 492.1316 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 551.8096 492.1316 Tm ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 556.7996 492.1316 Tm ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 561.7896 492.1316 Tm ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 56.2021 477.1316 Tm .0696 Tw [(gener)25.1(al popula)5.1(tion in or)25.1(der t)15.1(o)0( a)5.1(t)0(t)15.1(enua)5.1(t)15.1(e)0( sk)25.1(eletal muscle w)20(a)0(s)10(ting. Ho)25.2(w)25.1(e)25.2(v)30(e)0(r)90.1(,)0( ther)25.2(e is s)10(till some w)20(a)20(y)0( t)15.1(o)0( go)]TJ ET EMC /P <>BDC BT 9.5 0 0 9.5 546.82 477.1316 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 56.2021 462.1316 Tm .1108 Tw [(bef)10(or)25.1(e c)15.1(onsensus is r)25.1(eached on wha)5.1(t those ideal tar)25.2(gets should be)10(, particularly in specific critical car)25.2(e)]TJ ET EMC /P <>BDC BT 9.5 0 0 9.5 546.8198 462.1316 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 9.5 0 0 9.5 56.2021 447.1316 Tm .03 Tw [(subsets such as those f)10(ollo)25.1(wing tr)25.1(auma or r)25.1(e)0(c)15.1(eiving c)15.1(ontinuous r)25.1(enal r)25.1(eplac)15.1(ement ther)25.2(ap)25.2(y)85.2(.)0( )]TJ ET EMC /P <>BDC /GS2 gs BT 8 0 0 8 31.1815 410.9833 Tm 0 0 0 1 k .0284 Tc .4672 Tw [(T)20(he las)10(t time critical car)25.1(e pr)25.1(ot)15.1(ein tar)25.1(gets w)25.1(e)0(r)25.1(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5028 410.9833 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 398.9833 Tm .2748 Tw [(discus)10(sed in detail in CN w)20(as in 20)5.1(17)100.1(, f)10(ollo)25.2(wing the)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.503 398.9833 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 386.9833 Tm .1564 Tw [(publica)5.1(tion of the 20)5.1(16 A)15.1(SPEN guideline)10(.)]TJ ET EMC /P <>BDC BT 4 0 0 4 197.9776 390.1708 Tm 0 Tw (6)Tj ET EMC /P <>BDC BT 8 0 0 8 200.5457 386.9833 Tm .1564 Tw [( Sinc)15.1(e then,)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5028 386.9833 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 374.9833 Tm .0284 Tc .4555 Tw [(ESPEN guidanc)15.1(e has been upda)5.1(t)15.1(ed and se)25.1(v)30(e)0(r)25.1(a)0(l)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5026 374.9833 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 254.7741 374.9833 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 362.9833 Tm .237 Tw [(r)25.1(ele)25.2(v)25.1(ant s)15.1(y)20(s)10(t)15.1(ema)5.1(tic r)25.2(e)25.2(vie)25.2(w)15.1(s)0( published t)15.1(o)0( help inf)10(orm)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5029 362.9833 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 350.9833 Tm .2137 Tw [(our pr)25.2(actic)15.1(e in specific pa)5.1(tient ca)5.1(t)15.1(egories.)]TJ ET EMC /P <>BDC BT 4 0 0 4 204.2938 354.1708 Tm -.0568 Tc [(1, 2, 7)100.1(,)0( 8)]TJ ET EMC /P <>BDC BT 8 0 0 8 219.1146 350.9833 Tm 0 Tc [( In this)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5026 350.9833 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 338.9833 Tm .0479 Tw [(r)25.1(e)25.2(vie)25.2(w w)25.2(e)0( will pr)25.2(o)30(vide a summary of r)25.1(e)0(c)15.1(ent guidelines,)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5028 338.9833 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 326.9833 Tm .015 Tc .435 Tw [(s)10(tudies, and the k)25.2(e)25.2(y)0( r)25.2(e)0(c)15.2(ommenda)5.1(tions f)10(or futur)25.2(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5017 326.9833 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 314.9833 Tm -.0142 Tc -.022 Tw [(r)25.1(esear)25.1(ch design f)10(or pr)25.1(ot)15.1(ein dosing trials in the critically ill.)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.389 314.9833 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 250.6129 314.9833 Tm ( )Tj ET EMC /P <>BDC /GS1 gs BT /TT2 1 Tf 12 0 0 12 31.1815 294.314 Tm .34 1 .19 .01 k .03 Tw [(Curr)22.2(ent guideline r)22.2(e)0(c)15.1(ommenda)5.1(tions)]TJ ET EMC /P <>BDC BT 12 0 0 12 245.9612 294.314 Tm .27 .93 .68 .19 k 0 Tw ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 31.1815 279.2794 Tm 0 0 0 1 k .2004 Tw [(T)20(he mos)10(t r)25.2(e)0(c)15.1(ently upda)5.1(t)15.1(ed of the major critical car)25.1(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5028 279.2794 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 252.5057 279.2794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 256.5087 279.2794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 260.5116 279.2794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 264.5145 279.2794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 268.5174 279.2794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 272.5203 279.2794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 276.5231 279.2794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 267.0794 Tm .1502 Tw [(nutrition guidelines is ESPEN, which r)25.2(e)0(c)15.1(ommends the)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5028 267.0794 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 254.8794 Tm .03 Tw [(f)10(ollo)25.1(wing r)25.2(egar)25.2(ding pr)25.2(ot)15.1(ein pr)25.1(o)30(vision in critical car)25.1(e:)]TJ ET EMC /P <>BDC BT 4 0 0 4 236.5172 258.0669 Tm 0 Tw (7)Tj ET EMC /P <>BDC BT 8 0 0 8 238.8651 254.8794 Tm ( )Tj ET EMC /P <>BDC BT /TT4 1 Tf 8 0 0 8 45.3547 242.6794 Tm .2129 Tw (During critical illness, 1.3 g/kg protein equivalents)Tj ET EMC /P <>BDC BT 8 0 0 8 248.5028 242.6794 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 230.4794 Tm .03 Tw (per day can be added progressively.)Tj ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 174.5336 230.4794 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 45.3547 218.2794 Tm .0284 Tc .838 Tw [(T)20(his r)25.1(e)0(c)15.1(ommenda)5.1(tion is based lar)25.2(gely on)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5026 218.2794 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 206.0794 Tm .0061 Tc .4439 Tw [(observ)25.1(a)5.1(tional da)5.1(ta using mortality as the primary)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5026 206.0794 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 193.8794 Tm .2892 Tw [(out)15.1(c)15.1(ome \(the limita)5.1(tions of which will be discus)10(sed)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5027 193.8794 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 253.2164 193.8794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 257.9302 193.8794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 262.644 193.8794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 267.3578 193.8794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 181.6794 Tm .0284 Tc .4652 Tw [(la)5.1(t)15.1(er in this article)30(\) and is slightly higher than)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5026 181.6794 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 254.8518 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 261.201 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 267.5502 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 273.8995 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 280.2488 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 286.598 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 292.9472 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 299.2965 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 305.6458 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 311.995 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 318.3442 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 324.6934 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 331.0428 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 337.392 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 343.7412 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 350.0904 181.6794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 169.4794 Tm .0284 Tc .4457 Tw [(the minimum le)25.1(v)30(el r)25.1(e)0(c)15.1(ommended in the A)15.1(SPEN)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5027 169.4794 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 254.6959 169.4794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 260.8892 169.4794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 157.2794 Tm (guidelines.)Tj ET EMC /P <>BDC BT 4 0 0 4 72.6856 160.4669 Tm (6)Tj ET EMC /P <>BDC BT 8 0 0 8 75.2535 157.2794 Tm -.0312 Tw [( T)20(his incr)25.2(eased r)25.2(e)0(c)15.1(ommenda)5.1(tion is f)10(ollo)25.2(wing)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5028 157.2794 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 145.0794 Tm .1592 Tw [(the publica)5.1(tion of a lar)25.2(ge)10(, r)25.2(etr)25.1(ospectiv)30(e observ)25.2(a)5.1(tional)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5028 145.0794 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 252.1761 145.0794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 255.8495 145.0794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 132.8794 Tm .1101 Tw [(s)10(tudy of nearly 1,200 critically ill adults which sho)25.2(w)25.2(e)0(d)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5028 132.8794 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 120.6794 Tm .0082 Tc .4418 Tw [(significant impr)25.1(o)30(v)30(ements in 60-da)20(y mortality with)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5034 120.6794 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 108.4794 Tm .0035 Tc .4465 Tw [(pr)25.1(ot)15.1(ein adminis)10(tr)25.1(a)5.1(tion of mor)25.1(e than 1.3 g/k)25.1(g/)70.1(da)20(y)85.2(.)]TJ ET EMC /P <>BDC BT 4 0 0 4 245.9355 111.6669 Tm 0 Tc 0 Tw (9)Tj ET EMC /P <>BDC BT 8 0 0 8 248.5034 108.4794 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 96.2795 Tm .1122 Tw [(R)10(e)0(c)15.1(ommended pr)25.1(ot)15.1(ein intak)25.2(es b)25.2(y)0( clinical c)15.1(ondition as)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5029 96.2795 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 84.0794 Tm .2511 Tw [(r)25.1(e)0(c)15.1(ommended b)25.2(y)0( the diff)10(er)25.2(ent guidelines ha)20(v)30(e)0( been)]TJ ET EMC /P <>BDC BT 8 0 0 8 248.5028 84.0794 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 71.8794 Tm .03 Tw (summarised in )Tj ET EMC /P <>BDC BT /F2 1 Tf 8 0 0 8 91.1656 71.8794 Tm [(T)114(able 1)]TJ ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 118.4295 71.8794 Tm 0 Tw (.)Tj ET EMC /P <>BDC BT 8 0 0 8 120.2694 71.8794 Tm ( )Tj ET EMC /P <>BDC BT /TT6 1 Tf 45.9995 0 0 41.4 29.1766 740.3602 Tm -.0277 Tc (Developments )Tj ET EMC /P <>BDC BT 45.9995 0 0 41.4 29.1766 702.3602 Tm .022 Tw (in Protein Provision )Tj ET EMC /P <>BDC BT 45.9995 0 0 41.4 29.1766 664.3602 Tm (in Critical Care)Tj ET EMC /P <>BDC BT /TT2 1 Tf 8 0 0 8 131.9433 644.2519 Tm 0 Tc .03 Tw [(T)127.2(om Hollis,)]TJ ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 175.0299 644.2519 Tm [( Senior Specialis)10(t Critical Car)25.2(e Dietitian, Guy)30(s and S)5.1(t)0( T)20(homas )]TJ ET EMC /P <>BDC BT 8 0 0 8 131.9433 632.2519 Tm [(NHS T)100.1(rus)10(t, and )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 8 0 0 8 193.5826 632.2519 Tm (James Jackson,)Tj ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 255.8226 632.2519 Tm [( A)25.2(d)0(v)25.2(anc)15.1(ed Dietitian f)10(or Critical Car)25.2(e)10(,)0( )]TJ ET EMC /P <>BDC BT 8 0 0 8 131.9433 620.2519 Tm [(S)5.1(t)0( Geor)25.1(ges Univ)30(ersity Hospitals NHS F)15.1(ounda)5.1(tion T)100.1(rus)10(t)]TJ ET EMC /P <>BDC BT 8 0 0 8 346.602 620.2519 Tm 0 Tw ( )Tj ET EMC /Figure <>BDC Q q 1 i 52.297 656.58 m 67.743 656.58 l 70.874 656.58 73.412 654.042 73.412 650.911 c 73.412 607.254 l 73.412 604.123 70.874 601.585 67.743 601.585 c 36.851 601.585 l 33.72 601.585 31.182 604.123 31.182 607.254 c 31.182 650.911 l 31.182 654.042 33.72 656.58 36.851 656.58 c h 349.002 620.252 m W* n 0 841.89 595.276 -841.89 re 297.645 420.96 m W n .015015 841.89 595.29 -841.89 re W n /GS1 gs q 43.211 0 0 55.651 30.848 601.256 cm /Im2 Do Q EMC /Figure <>BDC Q q 1 i 102.677 656.58 m 118.124 656.58 l 121.255 656.58 123.793 654.042 123.793 650.911 c 123.793 607.254 l 123.793 604.123 121.255 601.585 118.124 601.585 c 87.231 601.585 l 84.1 601.585 81.562 604.123 81.562 607.254 c 81.562 650.911 l 81.562 654.042 84.1 656.58 87.231 656.58 c h 349.002 620.252 m W* n 0 841.89 595.276 -841.89 re 297.645 420.96 m W n .015015 841.89 595.29 -841.89 re W n /GS1 gs q 42.754 0 0 55.469 81.343 601.311 cm /Im3 Do Q EMC /P <>BDC Q q 1 i 0 841.89 595.276 -841.89 re 297.645 420.96 m W n .015015 841.89 595.29 -841.89 re W n /GS1 gs BT /F1 1 Tf 6 0 0 6 31.1815 43.9439 Tm 0 0 0 1 k 0 Tc .1063 Tw [(T)20(his is a r)25.2(eprint of an article tha)5.1(t f)10(e)0(a)5.1(tur)25.1(ed in C)10(omplet)15.1(e Nutrition \()30(CN\); 21\(8\): 25-28. T)20(he author and C)10(omplet)15.1(e Media & Mark)25.1(eti)]TJ 63.6905 0 TD [(ng L)20(t)15.1(d.)]TJ ET EMC /P <>BDC BT 6 0 0 6 434.6424 43.9439 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 6 0 0 6 437.08 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 439.5175 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 441.955 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 444.3926 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 446.8302 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 449.2677 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 451.7052 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 454.1428 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 456.5804 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 459.0179 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 461.4554 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 463.8931 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 466.3307 43.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 31.1815 34.9439 Tm .1037 Tw [(do not endorse an)15.1(y particular c)15.1(ompan)15.1(y)30(s pr)25.2(oducts or servic)15.1(es. T)20(he original article w)20(as c)15.1(ommis)10(sioned and plac)15.1(ed in CN b)25.2(y)0( Nutrino)]TJ 65.8414 0 TD -.03 Tc 0 Tw [(vo)-10(.)]TJ ET EMC /P <>BDC BT 6 0 0 6 434.6422 34.9439 Tm 0 Tc ( )Tj ET EMC /P <>BDC BT 6 0 0 6 437.0643 34.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 439.4863 34.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 441.9083 34.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 444.3303 34.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 446.7524 34.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 449.1744 34.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 451.5965 34.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 454.0184 34.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 456.4406 34.9439 Tm ( )Tj ET EMC /P <>BDC BT 6 0 0 6 31.1815 25.9439 Tm .0313 Tw [(CN ha)20(v)30(e)0( had no input int)15.1(o the c)15.1(ont)15.1(ent or r)25.1(e)25.1(vie)25.2(wing of this article)10(. T)20(his article is int)15.1(ended f)10(or healthcar)25.2(e pr)25.2(of)10(es)10(sionals only)85.2(.)]TJ 60.4087 0 TD [( T)20(he la)20(y)30(out of)]TJ ET EMC /P <>BDC BT 6 0 0 6 434.6419 25.9439 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 6 0 0 6 31.1815 16.9439 Tm .03 Tw [(this article is c)15.1(o)0(p)25.1(yright 20)10(21 C)10(omplet)15.1(e Media & Mark)25.2(eting L)20(t)15.1(d., publishers of CN. )]TJ ET EMC /Figure <>BDC Q q 1 i 451.497 61.546 119.871 -42.397 re W n 448.634 56.565 129.562 -41.821 re 277.891 16.944 m W* n 0 841.89 595.276 -841.89 re 297.645 420.96 m W n .015015 841.89 595.29 -841.89 re W n /GS1 gs q 119.943 0 0 37.686 451.497 19.149 cm /Im4 Do Q EMC /Artifact <>BDC Q q 1 i 0 841.89 595.276 -841.89 re 297.645 420.96 m W n .015015 841.89 595.29 -841.89 re W n 0 0 0 .08 k /GS1 gs q 1 0 0 1 416.552 404.647 cm 0 0 m 153.212 0 l 154.777 0 156.046 -1.2693 156.046 -2.835 c 156.046 -330.52 l 156.046 -332.086 154.777 -333.355 153.212 -333.355 c -153.212 -333.355 l -154.777 -333.355 -156.046 -332.086 -156.046 -330.52 c -156.046 -2.835 l -156.046 -1.2693 -154.777 0 -153.212 0 c h f* Q EMC /P <>BDC /GS2 gs BT /F2 1 Tf 9 0 0 9 260.2958 410.8898 Tm 0 0 0 1 k -.0217 Tc .03 Tw [(T)114(able 1: Curr)18.1(ent r)18.1(e)0(c)15.2(ommended pr)18.1(ot)15.2(ein intak)25.2(es in critical car)18.1(e guidelines)]TJ ET EMC /Artifact <>BDC 0 0 0 .7 k /GS1 gs 267.427 383.298 153.626 15.841 re f EMC /P <>BDC BT 8 0 0 8 273.096 388.7392 Tm 0 0 0 0 k 0 Tc [(Critically ill popula)5.1(tion)]TJ ET EMC /Artifact <>BDC 0 0 0 .7 k 421.053 383.298 144.567 15.841 re f EMC /P <>BDC BT 8 0 0 8 421.0533 388.7392 Tm 0 0 0 0 k [(R)10(e)0(c)15.1(ommended pr)18.1(ot)15.1(ein intak)25.2(es)]TJ ET EMC /P <>BDC /GS2 gs BT /TT2 1 Tf 8 0 0 8 273.096 373.958 Tm 0 0 0 1 k [(Gener)25.2(al ICU)]TJ ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 421.0533 373.398 Tm [(1.2-2.)20(0 g/k)25.2(g/)70.1(da)20(y)]TJ ET EMC /P <>BDC BT 4 0 0 4 484.9713 376.5855 Tm 0 Tw (6)Tj ET EMC /P <>BDC BT 8 0 0 8 487.5393 373.398 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 421.0533 362.398 Tm .03 Tw [(1.3 g/k)25.2(g/)70.1(da)20(y)]TJ ET EMC /P <>BDC BT 4 0 0 4 469.7875 365.5855 Tm 0 Tw (7)Tj ET EMC /P <>BDC BT 8 0 0 8 472.1354 362.398 Tm ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 8 0 0 8 273.096 347.116 Tm (Burns)Tj ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 421.0533 346.556 Tm .03 Tw [(1.5-2.)20(0 g/k)25.2(g/)70.1(da)20(y)]TJ ET EMC /P <>BDC BT 4 0 0 4 485.0912 349.7435 Tm (6, 7)Tj ET EMC /P <>BDC BT /TT2 1 Tf 8 0 0 8 273.096 331.7956 Tm 0 Tw (Obesity)Tj ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 421.0533 331.2356 Tm .03 Tw [(1.3 g/k)25.2(g adjus)10(t)15.1(ed B)15.1(W)100.1(/)70.1(d)0(a)20(y)]TJ ET EMC /P <>BDC BT 4 0 0 4 522.4324 334.4231 Tm 0 Tw (7)Tj ET EMC /P <>BDC BT 8 0 0 8 524.7804 331.2356 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 421.0533 320.2356 Tm .03 Tw [(BMI 30-40: 2.)20(0 g/k)25.2(g ideal B)15.1(W)100.1(/)70.1(d)0(a)20(y)]TJ ET EMC /P <>BDC BT 8 0 0 8 556.8734 320.2356 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 421.0533 309.2356 Tm .03 Tw [(BMI >40: 2.5 g/k)25.2(g ideal B)15.1(W)100.1(/)70.1(d)0(a)20(y)]TJ ET EMC /P <>BDC BT 4 0 0 4 547.3295 312.4231 Tm 0 Tw (7)Tj ET EMC /P <>BDC BT 8 0 0 8 549.6776 309.2356 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 552.3176 309.2356 Tm ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 8 0 0 8 273.096 294.1354 Tm [(R)10(enal*)]TJ ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 306.7921 293.5754 Tm .03 Tw [(Hospitalised pa)5.1(tient with)]TJ ET EMC /P <>BDC BT 8 0 0 8 405.007 293.5754 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 306.7921 282.5754 Tm .03 Tw [(AKI, AKI on CKD)40(, CKD)40(,)]TJ ET EMC /P <>BDC BT 8 0 0 8 396.4794 282.5754 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 399.1194 282.5754 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 401.7596 282.5754 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 404.3995 282.5754 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 407.0396 282.5754 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 306.7921 271.5754 Tm .03 Tw [(with acut)15.1(e/)80.1(critical illnes)10(s)]TJ ET EMC /P <>BDC BT 8 0 0 8 403.7583 271.5754 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 406.3983 271.5754 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 409.0383 271.5754 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 411.6783 271.5754 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 306.7921 260.5754 Tm .03 Tw [(not on KR)10(T)]TJ ET EMC /P <>BDC BT 8 0 0 8 421.0533 293.5754 Tm [(S)5.1(tart with 1 g/k)25.2(g/)70.1(da)20(y and gr)25.1(adually)]TJ ET EMC /P <>BDC BT 8 0 0 8 560.9932 293.5754 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 421.0533 282.5754 Tm .03 Tw [(incr)25.2(ease t)15.1(o)0( 1.3 g/k)25.2(g/)70.1(da)20(y if t)15.1(oler)25.2(a)5.1(t)15.1(ed)]TJ ET EMC /P <>BDC BT 4 0 0 4 561.2528 285.7629 Tm 0 Tw (10)Tj ET EMC /P <>BDC BT 8 0 0 8 306.7921 244.5767 Tm .03 Tw [(Critically ill pa)5.1(tients with)]TJ ET EMC /P <>BDC BT 8 0 0 8 403.5831 244.5767 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 406.2231 244.5767 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 306.7921 233.5767 Tm .03 Tw (AKI or AKI on CKD or CKD)Tj ET EMC /P <>BDC BT 8 0 0 8 413.5201 233.5767 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 306.7921 222.5767 Tm .03 Tw [(with KF on c)15.1(o)0(n)20(v)30(entional)]TJ ET EMC /P <>BDC BT 8 0 0 8 402.7906 222.5767 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 306.7921 211.5767 Tm .03 Tw [(int)15.1(ermitt)15.1(ent KRF)]TJ ET EMC /P <>BDC BT 8 0 0 8 421.0533 244.5767 Tm [(1.3-)30(1.5 g/k)25.2(g/)70.1(da)20(y)]TJ ET EMC /P <>BDC BT 4 0 0 4 482.1713 247.7642 Tm 0 Tw (10)Tj ET EMC /P <>BDC BT 8 0 0 8 306.7921 195.578 Tm .03 Tw [(Critically ill pa)5.1(tients with)]TJ ET EMC /P <>BDC BT 8 0 0 8 403.5831 195.578 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 406.2231 195.578 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 408.8631 195.578 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 306.7921 184.578 Tm .03 Tw (AKI or AKI on CKD or CKD)Tj ET EMC /P <>BDC BT 8 0 0 8 413.5201 184.578 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 306.7921 173.578 Tm .03 Tw [(with KF on CKR)10(T or PIKR)10(T)]TJ ET EMC /P <>BDC BT 8 0 0 8 421.0533 195.578 Tm [(1.5-)30(1.)20(7 g/k)25.2(g/)70.1(da)20(y)]TJ ET EMC /P <>BDC BT 4 0 0 4 481.827 198.7655 Tm 0 Tw (10)Tj ET EMC /P <>BDC BT /TT2 1 Tf 8 0 0 8 273.096 159.6404 Tm [(T)89.1(r)25.2(auma)]TJ ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 421.0533 159.0804 Tm .03 Tw [(Higher end of 1.2-2.)20(0 g/k)25.1(g/)70.1(da)20(y)]TJ ET EMC /P <>BDC BT 4 0 0 4 541.8913 162.2679 Tm 0 Tw (6)Tj ET EMC /P <>BDC BT 8 0 0 8 544.4594 159.0804 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 421.0533 148.0804 Tm .03 Tw [(1.5-2.)20(0 g/k)25.2(g/)70.1(da)20(y)]TJ ET EMC /P <>BDC BT 4 0 0 4 485.0912 151.2679 Tm 0 Tw (7)Tj ET EMC /P <>BDC BT 8 0 0 8 487.4393 148.0804 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 421.0533 137.0804 Tm .03 Tw [(No r)25.2(eport)15.1(ed benefits >2.2 g/k)25.1(g/)70.1(da)20(y)]TJ ET EMC /P <>BDC BT 8 0 0 8 561.8812 137.0804 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 8 0 0 8 273.096 122.8257 Tm .03 Tw [(T)89.1(r)25.2(auma)5.1(tic Br)25.1(ain Injury)]TJ ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 421.0533 122.2657 Tm [(1.5-2.5 g/k)25.2(g/)70.1(da)20(y)]TJ ET EMC /P <>BDC BT 4 0 0 4 484.4114 125.4532 Tm 0 Tw (6)Tj ET EMC /Artifact <>BDC 0 0 0 .5 K 0 J 0 j .5 w 10 M [] 0 d /GS1 gs q 1 0 0 1 267.427 357.206 cm 0 0 m 153.626 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 421.053 357.206 cm 0 0 m 144.567 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 267.427 341.886 cm 0 0 m 153.626 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 421.053 341.886 cm 0 0 m 144.567 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 267.427 304.226 cm 0 0 m 153.626 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 421.053 304.226 cm 0 0 m 144.567 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 267.427 255.227 cm 0 0 m 39.365 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 306.792 255.227 cm 0 0 m 114.261 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 421.053 255.227 cm 0 0 m 144.567 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 267.427 206.228 cm 0 0 m 39.365 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 306.792 206.228 cm 0 0 m 114.261 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 421.053 206.228 cm 0 0 m 144.567 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 267.427 168.231 cm 0 0 m 153.626 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 421.053 168.231 cm 0 0 m 144.567 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 267.427 131.916 cm 0 0 m 153.626 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 421.053 131.916 cm 0 0 m 144.567 0 l S Q EMC /P <>BDC /GS2 gs BT /TT2 1 Tf 5 0 0 5 269.0267 111.5663 Tm -.0276 Tc [(Key)-27.6(:)]TJ ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 279.5359 111.5663 Tm 0 Tc .03 Tw [( )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 285.1859 111.5663 Tm 0 Tw (AKI )Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 295.8359 111.5663 Tm .03 Tw [( acut)15.1(e kidne)25.1(y injury )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 352.4145 111.5663 Tm -.0151 Tc 0 Tw (BW)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 361.4839 111.5663 Tm 0 Tc .03 Tw [( body w)25.1(eight )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 404.1732 111.5663 Tm 0 Tw (CKD)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 415.3683 111.5663 Tm .03 Tw [( chr)25.1(onic kidne)25.1(y disease )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 482.7867 111.5663 Tm 0 Tw [(CKR)7.1(T)]TJ ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 496.8914 111.5663 Tm .03 Tw [( c)15.1(ontinuous kidne)25.1(y )]TJ ET EMC /P <>BDC BT 5 0 0 5 554.395 111.5663 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 269.0267 104.5663 Tm .03 Tw [(r)25.2(eplac)15.1(ement ther)25.1(ap)25.1(y )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 325.819 104.5663 Tm 0 Tw (ICU)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 334.7589 104.5663 Tm .03 Tw [( int)15.1(ensiv)30(e car)25.1(e unit )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 391.1725 104.5663 Tm 0 Tw (KF)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 398.0474 104.5663 Tm .03 Tw [( kidne)25.1(y f)15.1(ailur)25.1(e )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 442.3853 104.5663 Tm 0 Tw (KRF)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 452.8753 104.5663 Tm .03 Tw [( kidne)25.1(y r)25.1(eplac)15.1(ement ther)25.1(ap)25.2(y)]TJ ET EMC /P <>BDC BT 5 0 0 5 527.7517 104.5663 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 269.0267 97.5663 Tm ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 273.0269 97.5663 Tm [(PIKR)7.1(T)]TJ ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 288.2364 97.5663 Tm .03 Tw [( pr)25.1(olonged int)15.1(ermitt)15.1(ent kidne)25.1(y r)25.1(eplac)15.1(ement ther)25.1(ap)25.1(y)]TJ ET EMC /P <>BDC BT 5 0 0 5 420.8807 97.5663 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 269.0267 89.149 Tm .03 Tw [(*F)15.1(or r)25.2(enal pa)5.1(tients, the r)25.1(e)0(c)15.1(ommenda)5.1(tion is t)15.1(o)0( use pr)25.1(e-hospitalisa)5.1(tion B)15.1(W)0( or usual B)15.1(W)0( ins)10(t)15.1(ead of ideal B)15.1(W)100.1(. )]TJ ET EMC /P <>BDC BT 5 0 0 5 269.0267 82.149 Tm [(A)25.1(ctual B)15.1(W)0( should not be used f)10(or a pr)25.1(ot)15.1(ein pr)25.1(escription)]TJ ET EMC /P <>BDC BT 2.5 0 0 2.5 408.2433 84.149 Tm 0 Tw (10)Tj ET EMC /P <>BDC BT 5 0 0 5 410.8557 82.149 Tm ( )Tj ET EMC /Figure <>BDC Q q 1 i 28.366 831.358 108.988 -218.182 re W n 29.197 827.012 112.28 -47.45 re 412.356 82.149 m W* n 0 841.89 595.276 -841.89 re 297.645 420.96 m W n .015015 841.89 595.29 -841.89 re W n /GS1 gs BT /F3 1 Tf 53.88 0 0 53.88 29.1896 785.1835 Tm .34 1 .19 .01 k -.0803 Tc 0 Tw (CN)Tj ET 0 0 0 0 k q 1 0 0 1 128.225 789.782 cm 0 0 m .503 -.103 1.4932 -.5474 1.4932 -1.945 c 1.4932 -3.3351 .6582 -4.1109 -.5474 -4.1109 c -1.7008 -4.1109 -2.5879 -3.4006 -2.5879 -1.945 c -2.5879 -.6287 -1.7672 -.1182 -1.2126 -.0298 c -1.2126 -.5765 l -1.8708 -.7463 -2.1296 -1.2645 -2.1296 -1.945 c -2.1296 -3.0462 -1.4345 -3.5638 -.5474 -3.5638 c .4068 -3.5638 1.0352 -2.9872 1.0352 -1.945 c 1.0352 -1.1388 .5989 -.6873 0 -.5474 c 0 0 l f Q q 1 0 0 1 129.26 792.807 cm 0 0 m 0 1.0352 -.6582 1.6338 -1.5826 1.6338 c -2.5066 1.6338 -3.1648 1.0352 -3.1648 0 c -3.1648 -1.0358 -2.5066 -1.6346 -1.5826 -1.6346 c -.6582 -1.6346 0 -1.0358 0 0 c h -3.6231 0 m -3.6231 1.4786 -2.6546 2.1805 -1.5826 2.1805 c -.5105 2.1805 .458 1.4786 .458 0 c .458 -1.4789 -.5105 -2.182 -1.5826 -2.182 c -2.6546 -2.182 -3.6231 -1.4789 -3.6231 0 c f Q q 1 0 0 1 127.16 802.072 cm 0 0 m -.7022 0 -1.0647 -.3546 -1.0647 -1.1454 c -1.0647 -1.9885 -.5762 -2.4545 .1704 -2.4545 c 2.4408 -2.4545 l 2.4408 -3.0019 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841.89 595.275 -841.89 re 297.645 420.96 m W n .015015 841.89 595.29 -841.89 re W n /GS1 gs BT /TT2 1 Tf 12 0 0 12 22.677 776.4369 Tm .34 1 .19 .01 k 0 Tc .03 Tw [(Out)15.1(c)15.1(ome choic)15.1(e f)10(or trials)]TJ ET EMC /P <>BDC BT 12 0 0 12 174.5201 776.4369 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 12 0 0 12 22.677 761.4369 Tm .03 Tw [(in)20(v)30(e)0(s)10(tiga)5.1(ting pr)22.2(ot)15.1(ein)]TJ ET EMC /P <>BDC BT 12 0 0 12 145.4427 761.4369 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 12 0 0 12 22.677 746.4369 Tm .03 Tw [(pr)22.2(o)30(vision in the critically ill)]TJ ET EMC /P <>BDC BT 12 0 0 12 182.3823 746.4369 Tm .27 .93 .68 .19 k 0 Tw ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 22.677 731.0223 Tm 0 0 0 1 k .0021 Tc .4479 Tw [(Mortality has tr)25.2(aditionally been used as)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1484 731.0223 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 201.1484 731.0223 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1484 731.0223 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 213.1484 731.0223 Tm ( 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680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 217.9514 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 229.3527 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 240.7539 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 252.1549 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 263.5562 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 274.9573 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 286.3586 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 297.7597 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 309.161 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 320.562 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 331.9632 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 343.3645 680.7022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 668.1222 Tm .0284 Tc .554 Tw [(tha)5.1(t mortality ma)20(y not be the mos)10(t)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 668.1222 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 655.5422 Tm .0284 Tc 1.3523 Tw [(appr)25.2(opria)5.1(t)15.1(e)0( out)15.1(c)15.1(ome f)10(or nutrition)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 655.5422 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 642.9622 Tm .0229 Tc .4271 Tw [(int)15.2(erv)30.1(entions, especially with impr)25.2(o)30.1(ving)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1486 642.9622 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 201.1486 642.9622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1486 642.9622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 213.1486 642.9622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 219.1486 642.9622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 630.3822 Tm .1487 Tw [(ICU surviv)25.1(al r)25.2(a)5.1(t)15.1(es and the f)10(ocus on longer)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1494 630.3822 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 617.8022 Tm .4104 Tw [(t)15.1(erm, functional out)15.1(c)15.1(omes.)]TJ ET EMC /P <>BDC BT 4 0 0 4 134.2797 620.9897 Tm 0 Tw (12)Tj ET EMC /P <>BDC BT 8 0 0 8 137.9796 617.8022 Tm .4104 Tw [( Furthermor)25.2(e)10(,)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1493 617.8022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 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209.9891 517.1622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 214.9358 517.1622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 219.8824 517.1622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 504.5822 Tm .0115 Tc .4385 Tw [(is kno)25.1(wn t)15.1(o)0( incr)25.1(ease in critical illnes)10(s.)]TJ ET EMC /P <>BDC BT 4 0 0 4 192.802 507.7697 Tm 0 Tc 0 Tw (7)Tj ET EMC /P <>BDC BT 8 0 0 8 195.1502 504.5822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 201.1502 504.5822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1501 504.5822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 213.1501 504.5822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 219.1501 504.5822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 225.1501 504.5822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 231.1501 504.5822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 237.15 504.5822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 243.15 504.5822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 249.15 504.5822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 492.0022 Tm .0284 Tc .6232 Tw [(On ICU)15.1(, this pr)25.2(ot)15.1(eolytic activity can)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 492.0022 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 479.4222 Tm .0157 Tc .4343 Tw [(significantly outw)25.1(eigh pr)25.1(ot)15.1(ein s)15.1(ynthesis,)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1498 479.4222 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 466.8422 Tm .0033 Tc .4467 Tw [(leading t)15.1(o)-.1( r)25.1(a)-.1(pid and se)25.1(v)30(e)-.1(r)25.1(e)-.1( w)20(a)0(s)10(t)0(ing of)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1501 466.8422 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 454.2622 Tm .3019 Tw [(sk)25.1(eletal muscle)10(.)]TJ ET EMC /P <>BDC BT 4 0 0 4 86.3471 457.4497 Tm (3, 4)Tj ET EMC /P <>BDC BT 8 0 0 8 94.7708 454.2622 Tm [( W)10(hen ac)15.1(c)15.1(ompanied b)25.2(y)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 454.2622 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 441.6822 Tm .4357 Tw [(impair)25.1(ed muscular r)25.2(epair)90.1(, this in turn is)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1494 441.6822 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 429.1022 Tm .0173 Tc .4327 Tw [(as)9.9(socia)5.1(t)15.1(e)-.1(d with sus)9.9(tained, ICU-ac)9.9(q)0(uir)25.1(e)-.1(d)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1488 429.1022 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 416.5222 Tm .0284 Tc [(w)25.1(eaknes)10(s.)]TJ ET EMC /P <>BDC BT 4 0 0 4 64.4403 419.7097 Tm .6318 Tw (4, 5)Tj ET EMC /P <>BDC BT 8 0 0 8 74.618 416.5222 Tm [( T)20(his is one of the k)25.1(e)25.1(y)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1493 416.5222 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 403.9422 Tm .0284 Tc .8707 Tw [(c)15.1(omponents of P)5.1(o)0(s)10(t)0( Int)15.1(ensiv)30(e Car)25.2(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 403.9422 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 391.3622 Tm .0284 Tc .5755 Tw [(S)15.1(yndr)25.2(ome \(PICS\), which enc)15.1(ompas)10(ses)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 391.3622 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 202.38 391.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 209.611 391.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 216.8418 391.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 224.0728 391.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 231.3038 391.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 238.5346 391.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 245.7655 391.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 378.7822 Tm .0284 Tc .6674 Tw [(the pr)25.2(of)10(ound ph)15.1(y)20(sical, c)15.1(ognitiv)30(e and)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 378.7822 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 366.2022 Tm .0284 Tc 1.0812 Tw [(ps)15.1(y)30(chosocial impairments tha)5.1(t ma)20(y)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 366.2022 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 206.426 366.2022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 217.703 366.2022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 228.9801 366.2022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 240.2571 366.2022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 353.6223 Tm .3691 Tw [(pr)25.2(esent f)10(or months, or e)25.2(v)30(en y)30(ears, aft)15.1(er)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1493 353.6223 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 200.502 353.6223 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 205.8546 353.6223 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 211.2075 353.6223 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 216.5601 353.6223 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 341.0422 Tm .03 Tw [(ICU admis)10(sion.)]TJ ET EMC /P <>BDC BT 8 0 0 8 80.6931 341.0422 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 36.8504 328.4622 Tm .0284 Tc .4243 Tw [(It is ther)25.1(ef)10(or)25.1(e biologically plausible)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 328.4622 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 201.1704 328.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1917 328.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 213.2129 328.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 219.234 328.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 225.2554 328.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 315.8822 Tm .3854 Tw [(tha)5.1(t higher pr)25.2(ot)15.1(ein intak)25.2(es ma)20(y impr)25.1(o)30(v)30(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1494 315.8822 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 303.3022 Tm .133 Tw [(muscle pr)25.2(ot)15.1(ein s)15.1(ynthesis, ther)25.2(eb)25.1(y r)25.1(educing)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 303.3022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 290.7222 Tm .0284 Tc .5926 Tw [(the net ca)5.1(tabolic impact, a)5.1(t)0(t)15.1(enua)5.1(ting)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 290.7222 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 278.1422 Tm .29 Tw [(muscle w)20(a)0(s)10(ting, and impr)25.2(o)30(ving functional)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 278.1422 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 265.5622 Tm .1309 Tw [(out)15.1(c)15.1(omes and subsequently)85.2(, quality of lif)10(e)10(,)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1494 265.5622 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 252.9822 Tm .03 Tw [(aft)15.1(er critical car)25.2(e)10(.)]TJ ET EMC /P <>BDC BT 4 0 0 4 91.0907 256.1697 Tm (11, 14, 15)Tj ET EMC /P <>BDC BT 8 0 0 8 106.0068 252.9822 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 36.8504 240.3622 Tm .0284 Tc 1.3851 Tw [(Muscle w)20(a)0(s)10(ting and functional)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 240.3622 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 227.7422 Tm .0251 Tc .4249 Tw [(out)15.1(c)15.1(omes ar)25.1(e ther)25.1(ef)10(or)25.1(e incr)25.1(easingly of)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1481 227.7422 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 215.1222 Tm .0211 Tc .4289 Tw [(int)15.1(er)25.1(es)10(t in s)10(tudies in)20(v)30(e)0(s)10(tiga)5.1(ting pr)25.1(ot)15.1(ein)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 215.1222 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 202.5022 Tm .1869 Tw [(doses in the critically ill. Ho)25.1(w)25.2(e)25.2(v)30(er)90.1(, the use)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1493 202.5022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 199.0449 202.5022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 202.9403 202.5022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 206.8358 202.5022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 210.7314 202.5022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 189.8822 Tm .0026 Tc .4474 Tw [(of such measur)25.1(es as primary out)15.1(c)15.1(omes)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.148 189.8822 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 201.148 189.8822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.148 189.8822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 213.148 189.8822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 219.148 189.8822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 225.148 189.8822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 231.148 189.8822 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 177.2622 Tm .3094 Tw [(can be challenging, not leas)10(t due t)15.1(o)0( the)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 177.2622 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 164.6422 Tm .0255 Tc .4245 Tw (difficulties of obtaining and measuring)Tj ET EMC /P <>BDC BT 8 0 0 8 195.1491 164.6422 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 152.0223 Tm .0284 Tc 1.6876 Tw [(baseline measur)25.1(ements in these)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 152.0223 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 139.4023 Tm .249 Tw [(par)25.1(amet)15.1(ers, and the absenc)15.1(e of v)25.2(alida)5.1(t)15.1(e)0(d)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 139.4023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 126.7823 Tm .0284 Tc .5325 Tw [(t)15.1(ools f)10(or e)25.2(v)25.1(alua)5.1(ting pos)10(t-ICU ph)15.1(y)20(sical)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 126.7823 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 114.1624 Tm (function.)Tj ET EMC /P <>BDC BT 4 0 0 4 57.0051 117.3499 Tm (14)Tj ET EMC /P <>BDC BT 8 0 0 8 61.0011 114.1624 Tm ( )Tj ET EMC /P <>BDC BT /F2 1 Tf 8 0 0 8 36.8504 101.6623 Tm .3489 Tw [(T)114(able 2)]TJ ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 68.4014 101.6623 Tm .3489 Tc 0 Tw ( \()Tj ET EMC /P <>BDC BT /TT4 1 Tf 8 0 0 8 77.0326 101.6623 Tm 0 Tc .3489 Tw (see page 28)Tj ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 130.231 101.6623 Tm (\) summarises a)Tj ET EMC /P <>BDC BT 8 0 0 8 195.1493 101.6623 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 89.1623 Tm .2923 Tw [(r)25.2(ange of pot)15.1(ential out)15.1(c)15.1(ome measur)25.2(es f)10(o)0(r)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1491 89.1623 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 76.6624 Tm -.0097 Tw [(nutrition trials tha)5.1(t r)25.2(ela)5.1(t)15.1(e)0( t)15.1(o)0( muscle w)20(a)0(s)10(ting,)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1494 76.6624 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 64.1623 Tm .0022 Tc .4478 Tw [(s)10(t)0(r)25.1(ength, and functional s)10(t)0(a)5.1(tus, and the)]TJ ET EMC /P <>BDC BT 8 0 0 8 195.1488 64.1623 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 22.677 51.6623 Tm .03 Tw [(adv)25.1(antages and disadv)25.1(antages of each.)]TJ ET EMC /P <>BDC BT 4 0 0 4 178.9388 54.8498 Tm 0 Tw (14)Tj ET EMC /P <>BDC BT 8 0 0 8 182.9348 51.6623 Tm ( )Tj ET EMC /P <>BDC /GS1 gs BT /TT2 1 Tf 12 0 0 12 207.1493 776.4369 Tm .34 1 .19 .01 k .03 Tw [(Pr)22.2(ot)15.1(ein dose )]TJ ET EMC /P <>BDC BT 12 0 0 12 207.1493 761.4369 Tm [(and mortality out)15.1(c)15.1(ome)]TJ ET EMC /P <>BDC BT 12 0 0 12 344.1981 761.4369 Tm .27 .93 .68 .19 k 0 Tw ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 207.1493 746.0022 Tm 0 0 0 1 k .4043 Tw [(A number of observ)25.1(a)5.1(tional s)10(tudies ha)20(v)30(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 746.0022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 733.4022 Tm .1562 Tw [(sugges)10(t)15.1(ed an in)20(v)30(erse r)25.2(ela)5.1(tionship betw)25.2(een)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 733.4022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 720.8022 Tm .0284 Tc .6264 Tw [(pr)25.2(ot)15.1(ein deliv)30(ery and mortality)85.2(, wher)25.2(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 720.8022 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 708.2021 Tm .0619 Tw [(mortality has been the primary out)15.1(c)15.1(ome)10(.)]TJ ET EMC /P <>BDC BT 4 0 0 4 370.2935 711.3896 Tm 0 Tw [(16-)30(19)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 708.2021 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 695.6022 Tm .0265 Tc .4235 Tw [(E)10(videnc)15.1(e fr)25.1(om observ)25.1(a)5.1(tional s)10(tudies is)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6209 695.6022 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 683.0022 Tm -.02 Tc .3231 Tw [(a)-20(l)-20(ways)-20( s)-10(t)-20(r)]TJ 5.1479 0 TD 0 Tc .3031 Tw [(onger when support)15.1(ed b)25.2(y)0( RCT)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6216 683.0022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 670.4022 Tm .0485 Tw [(findings. As y)30(et, clear as)10(socia)5.1(tions betw)25.2(een)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6217 670.4022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 657.8022 Tm .1962 Tw [(pr)25.2(ot)15.1(ein dose and mortality ha)20(v)30(e)0( not been)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6216 657.8022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 645.2022 Tm .0236 Tc .4264 Tw [(seen in published RCT)100.1(, but s)10(tudies t)15.2(o)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 645.2022 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 385.6212 645.2022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6212 645.2022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 397.6212 645.2022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 403.6212 645.2022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 409.6212 645.2022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 632.6022 Tm .2179 Tw [(da)5.1(t)15.1(e)0( w)25.2(e)0(r)25.2(e)0( either not specifically designed)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 632.6022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 383.7648 632.6022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 387.9082 632.6022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 392.0515 632.6022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 620.0022 Tm .4052 Tw [(t)15.1(o)0( c)15.1(ompar)25.2(e tw)25.1(o diff)10(er)25.2(ent pr)25.2(ot)15.1(ein doses,)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 620.0022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 385.263 620.0022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 390.9047 620.0022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 396.5463 620.0022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 402.1879 620.0022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 407.8297 620.0022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 413.4713 620.0022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 607.4022 Tm .0284 Tc .5502 Tw (or didnt use mortality as a primary)Tj ET EMC /P <>BDC BT 8 0 0 8 379.6212 607.4022 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 594.8022 Tm [(out)15.1(c)15.1(ome)10(.)]TJ ET EMC /P <>BDC BT 4 0 0 4 243.859 597.9897 Tm (20-22)Tj ET EMC /P <>BDC BT 8 0 0 8 255.411 594.8022 Tm .1981 Tw [( As such, w)25.2(e)0( ar)25.2(e s)10(till a)20(w)20(aiting)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 594.8022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 582.2022 Tm .0284 Tc .8955 Tw [(published RCT tha)5.1(t ar)25.2(e specifically)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 582.2022 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 569.6021 Tm .03 Tw [(designed t)15.1(o)0( look a)5.1(t)0( this r)25.2(ela)5.1(tionship)10(. )]TJ ET EMC /P <>BDC BT 8 0 0 8 353.1209 569.6021 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 221.3225 556.9622 Tm .1507 Tw [(A)25.1(dding t)15.1(o)0( this, thr)25.2(ee r)25.2(e)0(c)15.1(ent s)15.1(y)20(s)10(t)15.1(ema)5.1(tic)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 556.9622 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 544.3222 Tm .0284 Tc .4638 Tw [(r)25.2(e)25.1(vie)25.1(w)15.1(s)0( f)10(ound no significant eff)10(ect of)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 544.3222 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 531.6822 Tm .1299 Tw [(pr)25.2(ot)15.1(ein dose on mortality risk.)]TJ ET EMC /P <>BDC BT 4 0 0 4 329.1195 534.8697 Tm (1, 2, 8)Tj ET EMC /P <>BDC BT 8 0 0 8 340.6187 531.6822 Tm -.0271 Tc .157 Tw [( H)-27.1(oweve)-27.1(r)63(,)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 531.6822 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 519.0421 Tm .2098 Tw [(limita)5.1(tions e)30(xis)10(t in t)15.1(erms of het)15.1(er)25.2(ogeneity)85.2(,)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 519.0421 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 506.4022 Tm .0284 Tc .4615 Tw [(s)10(tudy design, and importantly)85.2(, pr)25.2(ot)15.1(ein)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 506.4022 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 385.9403 506.4022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 392.2592 506.4022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 398.5782 506.4022 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 493.7622 Tm .0171 Tc .4329 Tw [(dose)10(. In F)15.1(ett)15.1(erplac)15.1(e )]TJ ET EMC /P <>BDC BT /TT4 1 Tf 8 0 0 8 300.4522 493.7622 Tm (et al.)Tj ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 323.3844 493.7622 Tm [( \(20)10(20\),)]TJ ET EMC /P <>BDC BT 4 0 0 4 359.7834 496.9497 Tm 0 Tc 0 Tw (2)Tj ET EMC /P <>BDC BT 8 0 0 8 362.2119 493.7622 Tm .0071 Tc .4429 Tw [( fo)-10(r)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6218 493.7622 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 481.1222 Tm .4049 Tw [(e)30(x)15.1(ample)10(, the pr)25.2(ot)15.1(ein int)15.1(erv)30(ention gr)25.2(oup)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 481.1222 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 468.4822 Tm .3233 Tw [(w)20(as a mean of 1.3 g \(SD 0)20(.)20(08\) pr)25.2(ot)15.1(ein/)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6216 468.4822 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 455.8422 Tm .3271 Tw [(k)25.2(g)0(/)70.1(d)0(a)20(y)85.2(, with usual car)25.2(e a mean of 0)20(.)20(7)25.2(5)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 455.8422 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 443.2022 Tm .0459 Tw [(g/k)25.2(g/)70.1(da)20(y \(SD 0)20(.)50(15\), wher)25.2(eas in Da)20(vies )]TJ ET EMC /P <>BDC BT /TT4 1 Tf 8 0 0 8 360.606 443.2022 Tm (et al.)Tj ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 379.6212 443.2022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 430.5622 Tm [(\(20)5.1(17\),)]TJ ET EMC /P <>BDC BT 4 0 0 4 233.6043 433.7497 Tm (1)Tj ET EMC /P <>BDC BT 8 0 0 8 234.9443 430.5622 Tm .3055 Tw [( the mean high and lo)25.2(w pr)25.2(ot)15.1(ein)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 430.5622 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 417.9222 Tm .1455 Tw [(gr)25.2(oups w)25.2(e)0(r)25.2(e)0( 1.)20(0)10(2)0( g/k)25.2(g \(SD 0)20(.42\) and 0)20(.)0(6)25.1(7)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 417.9222 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 405.2822 Tm .014 Tc .436 Tw [(g/k)25.2(g/)70.1(da)20(y \(SD 0)20(.38\), r)25.2(espectiv)30(ely)85.2(. W)10(hile)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6203 405.2822 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 392.6422 Tm .4051 Tw [(these numbers ma)20(y r)25.2(eflect the pr)25.2(actical)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 392.6422 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 380.0022 Tm .3055 Tw [(r)25.2(ealities of pr)25.2(escription v)30(ersus deliv)30(ery in)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6216 380.0022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 367.3622 Tm .0094 Tc .4406 Tw [(t)15.2(erms of ent)15.2(er)25.2(al nutrition on ICU)15.2(, the)25.2(y)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6225 367.3622 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 385.6225 367.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6223 367.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 397.6223 367.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 403.6223 367.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 409.6223 367.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 415.6223 367.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 421.6223 367.3622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 354.7222 Tm .272 Tw [(ar)25.1(e)10(,)0( a)5.1(t)0( bes)10(t, near the bott)15.1(om end of the)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 354.7222 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 384.1978 354.7222 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 388.7742 354.7222 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 393.3507 354.7222 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 397.927 354.7222 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 402.5035 354.7222 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 342.0822 Tm .447 Tw [(pr)25.2(ot)15.1(ein tar)25.2(gets r)25.2(e)0(c)15.1(ommended in curr)25.2(ent)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 342.0822 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 329.4422 Tm .0284 Tc .4547 Tw [(guidelines, and perhaps ther)25.2(ef)10(or)25.2(e also)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 329.4422 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 316.8022 Tm .03 Tw [(c)15.1(ontribut)15.1(e t)15.1(o)0( the lack of observ)30(ed eff)10(ect.)]TJ ET EMC /P <>BDC BT 8 0 0 8 369.6897 316.8022 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 221.3225 304.1722 Tm .0284 Tc .5267 Tw [(T)135(o)0( further illus)10(tr)25.1(a)5.1(t)15.1(e the impact of)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 304.1722 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 386.4619 304.1722 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 291.5421 Tm -.0071 Tc -.0157 Tw [(subject het)15.1(er)25.1(ogeneity)85.2(, a r)25.1(e)0(c)15.1(ent r)25.1(etr)25.1(ospectiv)30(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.5646 291.5421 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 278.9121 Tm .0284 Tc .4559 Tw [(observ)25.1(a)5.1(tional s)10(tudy demons)10(tr)25.2(a)5.1(t)15.1(ed tha)5.1(t)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 278.9121 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 266.2821 Tm .0284 Tc .8247 Tw [(early adminis)10(tr)25.1(a)5.1(tion of high pr)25.1(ot)15.1(ein)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 266.2821 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 388.846 266.2821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 398.0707 266.2821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 407.2954 266.2821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 416.5201 266.2821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 425.7448 266.2821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 434.9695 266.2821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 444.1942 266.2821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 253.6521 Tm .1266 Tw [(\(mean pr)25.2(ot)15.1(ein intak)25.2(e >1.2 g/k)25.2(g/)70.1(da)20(y on ICU)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 253.6521 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 241.0221 Tm .3035 Tw [(admis)10(sion da)20(y)20(s)0( 2-4\) w)20(as as)10(socia)5.1(t)15.1(ed with)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 241.0221 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 228.3921 Tm .3581 Tw [(lo)25.2(w)25.2(er mortality in critically pa)5.1(tients than)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6216 228.3921 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 384.8864 228.3921 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 390.151 228.3921 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 395.4158 228.3921 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 215.7621 Tm .0284 Tc .4837 Tw [(lo)25.1(w pr)25.1(ot)15.1(ein \(mean pr)25.1(ot)15.1(ein intak)25.2(e <1.2)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 215.7621 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 203.1321 Tm .0664 Tw [(g/k)25.2(g/)70.1(da)20(y on da)20(y)20(s)0( 2-4\) but only f)10(or those)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6217 203.1321 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 190.5021 Tm .0107 Tc .4393 Tw [(pa)5.1(tients with lo)25.1(w sk)25.1(eletal muscle mas)10(s)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6223 190.5021 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 385.6223 190.5021 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6223 190.5021 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 397.6223 190.5021 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 403.6223 190.5021 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 409.6222 190.5021 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 415.6222 190.5021 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 177.8721 Tm .0284 Tc .4933 Tw [(and density)85.2(, measur)25.1(ed using r)25.2(outinely)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 177.8721 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 165.2421 Tm .0224 Tc .4276 Tw [(a)20.1(v)25.2(ailable CT scans a)5.2(t).1( admis)10.1(sion.)]TJ ET EMC /P <>BDC BT 4 0 0 4 352.2093 168.4296 Tm 0 Tw (23)Tj ET EMC /P <>BDC BT 8 0 0 8 357.1881 165.2421 Tm .4276 Tw [( T)20.1(his)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6202 165.2421 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 152.6121 Tm .0095 Tc .4405 Tw [(as)10(socia)5.1(tion w)20(as significant f)10(or both 60)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6219 152.6121 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 385.6219 152.6121 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6219 152.6121 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 397.6219 152.6121 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 403.6219 152.6121 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 409.6219 152.6121 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 139.9821 Tm .0237 Tc .4263 Tw [(da)20(y \(p=0)20(.)20(0)0(0)5.1(1\) and six)30(-month mortality)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6209 139.9821 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 385.6209 139.9821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6209 139.9821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 397.6209 139.9821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 403.6209 139.9821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 409.6208 139.9821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 415.6208 139.9821 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 127.3521 Tm .1993 Tw [(\(p= 0)20(.)20(0)10(2\) but w)20(as not seen in those with)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 127.3521 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 114.7221 Tm .4068 Tw [(either normal sk)25.2(eletal muscle density or)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 114.7221 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 102.0921 Tm .0284 Tc [(ar)25.1(ea.)]TJ ET EMC /P <>BDC BT 4 0 0 4 226.9798 105.2796 Tm (23)Tj ET EMC /P <>BDC BT 8 0 0 8 232.007 102.0921 Tm .4928 Tw [( T)20(his s)10(tudy sets the h)15.1(ypothesis)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 102.0921 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 386.191 102.0921 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 392.7608 102.0921 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 399.3304 102.0921 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 405.9002 102.0921 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 412.47 102.0921 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 419.0396 102.0921 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 425.6094 102.0921 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 89.4622 Tm .4412 Tw [(tha)5.1(t ther)25.2(e ma)20(y be a gr)25.2(oup of pa)5.1(tients)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 89.4622 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 385.5509 89.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.4806 89.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 397.4104 89.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 403.3402 89.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 409.2701 89.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 415.1997 89.4622 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 76.8321 Tm .1804 Tw [(who will benefit mor)25.2(e fr)25.2(om higher pr)25.2(ot)15.1(ein)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6212 76.8321 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 64.2021 Tm .1995 Tw [(intak)25.1(es and this r)25.2(equir)25.2(es e)30(xplor)25.2(a)5.1(tion in an)]TJ ET EMC /P <>BDC BT 8 0 0 8 379.6214 64.2021 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 207.1493 51.5721 Tm .03 Tw (RCT setting.)Tj ET EMC /P <>BDC BT 8 0 0 8 255.7252 51.5721 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /TT2 1 Tf 12 0 0 12 391.6215 776.4369 Tm .34 1 .19 .01 k .03 Tw [(Pr)22.2(ot)15.1(ein dose and muscle)]TJ ET EMC /P <>BDC BT 12 0 0 12 539.1813 776.4369 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 12 0 0 12 391.6215 761.4369 Tm .03 Tw [(r)22.2(ela)5.1(t)15.1(ed and functional)]TJ ET EMC /P <>BDC BT 12 0 0 12 522.6198 761.4369 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 12 0 0 12 391.6215 746.4369 Tm [(out)15.1(c)15.1(omes)]TJ ET EMC /P <>BDC BT 12 0 0 12 450.3461 746.4369 Tm .27 .93 .68 .19 k ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 391.6215 731.4023 Tm 0 0 0 1 k .0189 Tc .4311 Tw [(Good quality RCT in)20.1(v)30.1(e)0(s)10.1(tiga)5.2(ting pr)25.2(ot)15.2(ein)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0931 731.4023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 719.2023 Tm .0104 Tc .4396 Tw [(dose and muscle r)25.1(ela)5.1(t)15.1(ed out)15.1(c)15.1(omes ar)25.1(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0948 719.2023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 707.0023 Tm .0284 Tc 1.0969 Tw [(sparse)10(, meaning tha)5.1(t neither firm)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 707.0023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 694.8023 Tm .0284 Tc .6399 Tw [(r)25.2(e)0(c)15.1(ommenda)5.1(tions in major guidelines,)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 694.8023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 571.8396 694.8023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 579.5857 694.8023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 587.3318 694.8023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 595.0779 694.8023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 682.6023 Tm .0116 Tc .4384 Tw [(nor meta-analy)20(sis in s)15.2(y)20(s)10(t)15.2(ema)5.1(tic r)25.1(e)25.1(vie)25.1(w)15.1(s)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0944 682.6023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 670.4023 Tm .0284 Tc .6946 Tw [(e)30(xploring this as)10(socia)5.1(tion ha)20(v)30(e)0( been)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 670.4023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 658.2023 Tm [(pos)10(sible)10(.)]TJ ET EMC /P <>BDC BT 4 0 0 4 425.5892 661.3898 Tm (2,6-8)Tj ET EMC /P <>BDC BT 8 0 0 8 435.5893 658.2023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 405.7946 646.0023 Tm .1568 Tw [(T)20(h)0(a)5.1(t)0( said, some pr)25.2(omising r)25.2(esults ha)20(v)30(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 646.0023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 633.8023 Tm .0887 Tw [(been seen in individual s)10(tudies. F)15.1(ett)15.1(erplac)15.1(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 633.8023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT4 1 Tf 8 0 0 8 391.6215 621.6023 Tm .0954 Tw (et al.)Tj ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 411.0324 621.6023 Tm [( \(20)5.1(18\),)]TJ ET EMC /P <>BDC BT 4 0 0 4 440.9946 624.7898 Tm -.03 Tc 0 Tw (24)Tj ET EMC /P <>BDC BT 8 0 0 8 445.8904 621.6023 Tm 0 Tc .0954 Tw [( f)10(ound a significant r)25.1(eduction)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0936 621.6023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 609.4023 Tm .0309 Tw [(in los)10(s of quadric)15.1(eps muscle la)20(y)30(er thicknes)10(s)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 609.4023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 597.2023 Tm -.0071 Tc -.0212 Tw [(a)5.1(t)0( dischar)25.1(ge in a higher pr)25.1(ot)15.1(ein gr)25.1(oup \(mean)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0367 597.2023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 585.0023 Tm .2193 Tw [(1.2 \(SD 0)20(.30\) g/k)25.2(g/)70.1(da)20(y\) c)15.1(ompar)25.2(ed t)15.1(o)0( lo)25.2(w)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0934 585.0023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 572.8023 Tm .0005 Tc .4495 Tw [(pr)25.2(ot)15.2(ein \(mean 0)20(.)20(7)25.2(5 \(SD 0)20(.)50.1(11\) g/k)25.2(g/)70.1(da)20(y\),)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.093 572.8023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 570.0929 572.8023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 576.0929 572.8023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 582.0929 572.8023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 588.0929 572.8023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 594.0929 572.8023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 560.6023 Tm .2842 Tw [(as measur)25.1(ed b)25.1(y)0( ultr)25.2(asound. Ho)25.2(w)25.1(e)25.2(v)30(e)0(r)90.1(,)0( the)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0936 560.6023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 548.4023 Tm .2303 Tw [(same s)10(tudy f)10(ound no significant eff)10(ect of)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 548.4023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 536.2023 Tm .0606 Tw [(pr)25.2(ot)15.1(ein dose on hand grip s)10(t)0(r)25.2(ength, muscle)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 536.2023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 524.0023 Tm -.0183 Tw [(s)10(t)0(r)25.2(ength, ICU ac)10(quir)25.2(ed w)25.1(eaknes)10(s or ph)15.1(y)20(sical)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0936 524.0023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 511.8023 Tm -.0129 Tw [(function on ICU)15.1(, although ther)25.2(e w)20(as mis)10(sing)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 511.8023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 499.6023 Tm .0144 Tw [(da)5.1(ta in up t)15.1(o)0( 80% of participants. Mor)25.2(eo)30(v)30(e)0(r)90.1(,)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 499.6023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 487.4023 Tm .3751 Tw [(these w)25.2(e)0(r)25.1(e)0( all sec)15.1(ondary out)15.1(c)15.1(omes, and)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 487.4023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 475.2023 Tm .0462 Tw [(should ther)25.2(ef)10(or)25.2(e be c)15.1(onsider)25.2(ed h)15.1(ypothesis-)]TJ ET EMC /P <>BDC BT 8 0 0 8 391.6215 463.0023 Tm .03 Tw [(gener)25.2(a)5.1(ting r)25.2(esults only)85.2(. )]TJ ET EMC /P <>BDC BT 8 0 0 8 485.5924 463.0023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 405.7946 450.8023 Tm .0281 Tc .4219 Tw [(Similarly)85.2(, a 20)5.2(16 RCT of par)25.2(ent)15.2(er)25.2(al)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0928 450.8023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 438.6023 Tm .2447 Tw [(pr)25.2(ot)15.1(ein deliv)30(ery demons)10(tr)25.2(a)5.1(t)15.1(ed tha)5.1(t higher)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0936 438.6023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 426.4023 Tm -.0284 Tc -.0065 Tw [(pr)25.1(ot)15.1(ein deliv)30(ery \(mean 1.)50(17 \(SD 0)20(.21\) g/k)25.1(g/)70.1(da)20(y\))]TJ ET EMC /P <>BDC BT 8 0 0 8 563.8665 426.4023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 414.2023 Tm .2139 Tw [(v)20(s. lo)25.2(w)25.2(er pr)25.2(ot)15.1(ein deliv)30(ery \(mean 0)20(.)0(8)10(7)0( \(SD)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0936 414.2023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 402.0024 Tm .269 Tw [(1.)50(17\) g/k)25.2(g/)70.1(da)20(y\) r)25.1(esult)15.1(ed in gr)25.2(ea)5.1(t)15.1(er muscle)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 402.0024 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 389.8023 Tm .2271 Tw [(thicknes)10(s measur)25.2(ed b)25.2(y)0( ultr)25.2(asound on da)20(y)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0936 389.8023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 377.6023 Tm .0942 Tw [(se)25.1(v)30(en f)10(ollo)25.2(wing r)25.2(andomisa)5.1(tion.)]TJ ET EMC /P <>BDC BT 4 0 0 4 514.3472 380.7898 Tm 0 Tw (22)Tj ET EMC /P <>BDC BT 8 0 0 8 519.0671 377.6023 Tm .0942 Tw [( T)20(his eff)10(ect)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0936 377.6023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 365.4024 Tm .0628 Tw [(w)20(as seen when looking a)5.1(t)0( the sum of thr)25.2(ee)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0933 365.4024 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 353.2024 Tm .4057 Tw [(muscle sit)15.1(es \(f)10(or)25.2(earm, bic)15.1(eps and thigh,)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0934 353.2024 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 341.0024 Tm .0284 Tc .4258 Tw [(p=0)20(.)20(0)10(2\) and f)10(o)0(r)25.1(earm muscle thicknes)10(s)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0934 341.0024 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 328.8023 Tm .0086 Tc .4414 Tw [(\(p=0)20.1(.)20.1(000)5.2(1\). T)20.1(her)25.2(e w)20.1(as also significantly)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0948 328.8023 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 316.6023 Tm .2563 Tw [(impr)25.2(o)30(v)30(ed handgrip s)10(t)0(r)25.2(ength a)5.1(t)0( da)20(y se)25.1(v)30(e)0(n)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 316.6023 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 568.5444 316.6023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 572.9951 316.6023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 577.4458 316.6023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 581.8965 316.6023 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 304.4024 Tm .4271 Tw [(in the higher pr)25.2(ot)15.1(ein gr)25.2(oup \(p= 0)20(.)20(0)10(25\),)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 304.4024 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 569.9102 304.4024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 575.7269 304.4024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 581.5436 304.4024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 587.3602 304.4024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 593.177 304.4024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 292.2024 Tm .3543 Tw [(but this eff)10(ect w)20(as no longer significant)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0936 292.2024 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 569.3284 292.2024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 574.5632 292.2024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 579.798 292.2024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 585.0328 292.2024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 590.2675 292.2024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 280.0024 Tm .3627 Tw [(on dischar)25.2(ge fr)25.2(om ICU \(p=0)20(.)20(054\). A)25.1(gain)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 280.0024 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 267.8024 Tm .0064 Tc .4436 Tw [(though, when int)15.1(erpr)25.1(eting these r)25.1(esults,)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0941 267.8024 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 570.094 267.8024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 576.094 267.8024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 582.094 267.8024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 588.094 267.8024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 594.094 267.8024 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 255.6024 Tm .19 Tw [(it is important t)15.1(o)0( not)15.1(e tha)5.1(t these w)25.2(e)0(r)25.2(e)0( all)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0936 255.6024 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 243.4023 Tm .03 Tw [(sec)15.1(ondary out)15.1(c)15.1(omes. )]TJ ET EMC /P <>BDC BT 8 0 0 8 478.5622 243.4023 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /TT2 1 Tf 12 0 0 12 391.6215 222.7331 Tm .34 1 .19 .01 k .03 Tw [(Curr)22.2(ent r)22.2(esear)22.2(ch)]TJ ET EMC /P <>BDC BT 12 0 0 12 491.1896 222.7331 Tm .27 .93 .68 .19 k 0 Tw ( )Tj ET EMC /P <>BDC BT 12 0 0 12 495.1497 222.7331 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 391.6215 207.8985 Tm 0 0 0 1 k .348 Tw [(A r)25.2(e)25.2(vie)25.2(w of the curr)25.2(ent trials, r)25.2(egis)10(t)15.1(e)0(r)25.2(e)0(d)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 207.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 569.2776 207.8985 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 574.4617 207.8985 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 579.6458 207.8985 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 584.8298 207.8985 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 590.0139 207.8985 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 595.198 207.8985 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 195.8985 Tm .0284 Tc .8349 Tw [(on a single clinical trials da)5.1(tabase)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0934 195.8985 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 183.8985 Tm (\()Tj ET EMC /P <>BDC BT /TT2 1 Tf 8 0 0 8 395.0614 183.8985 Tm [(https:/)167(/)80.1(clinicaltrials.)10(go)30(v)70.1(/)]TJ ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 490.668 183.8985 Tm .0282 Tw [(\), in)20(v)30(e)0(s)10(tiga)5.1(ting the)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 183.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 171.8985 Tm .273 Tw [(r)25.2(ole of pr)25.2(ot)15.1(ein dosing on out)15.1(c)15.1(omes fr)25.2(om)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0935 171.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 159.8985 Tm .222 Tw [(critical illnes)10(s, has identified these curr)25.2(ent)]TJ ET EMC /P <>BDC BT 8 0 0 8 564.0936 159.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6215 147.8985 Tm (themes:)Tj ET EMC /P <>BDC BT 8 0 0 8 422.5733 147.8985 Tm ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 8 0 0 8 391.6215 135.8985 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 397.7254 135.8985 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.1253 135.8985 Tm .03 Tw [(R)10(educing the se)25.2(v)30(erity of ICU ac)10(quir)25.2(ed )]TJ ET EMC /P <>BDC BT 8 0 0 8 392.9254 123.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.1253 123.8985 Tm .03 Tw [(w)25.1(eaknes)10(s b)25.2(y)0( early int)15.1(erv)30(ention with high )]TJ ET EMC /P <>BDC BT 8 0 0 8 392.9254 111.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.1253 111.8985 Tm .03 Tw [(pr)25.2(ot)15.1(ein ent)15.1(er)25.2(al nutrition t)15.1(ogether with )]TJ ET EMC /P <>BDC BT 8 0 0 8 392.9254 99.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.1253 99.8985 Tm [(mobility)85.2(.)]TJ ET EMC /P <>BDC BT 8 0 0 8 433.1716 99.8985 Tm ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 8 0 0 8 391.6215 87.8985 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 397.7254 87.8985 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.1253 87.8985 Tm .03 Tw [(T)20(he eff)10(ect of high v)30(ersus s)10(tandar)25.2(d )]TJ ET EMC /P <>BDC BT 8 0 0 8 392.9254 75.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.1253 75.8985 Tm .03 Tw [(pr)25.2(ot)15.1(ein pr)25.2(o)30(vision on functional r)25.2(e)0(c)15.1(o)30(v)30(ery )]TJ ET EMC /P <>BDC BT 8 0 0 8 392.9254 63.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.1253 63.8985 Tm .03 Tw [(of critically ill pa)5.1(tient b)25.2(y)0( f)10(ocus)10(sing on )]TJ ET EMC /P <>BDC BT 8 0 0 8 392.9254 51.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.1253 51.8985 Tm .03 Tw [(functional, pa)5.1(tient c)15.1(entr)25.2(ed out)15.1(c)15.1(omes.)]TJ ET EMC /P <>BDC BT 8 0 0 8 547.6958 51.8985 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /TT2 1 Tf 9 0 0 9 22.677 809.4773 Tm 0 0 0 .5 k .03 Tw [(Nutrino)30(v)30(o)0( | )]TJ ET EMC /P <>BDC /GS2 gs BT 9 0 0 9 81.5006 809.4773 Tm 0 0 0 1 k [(Pr)22.2(ot)15.1(ein Pr)22.2(o)30(vision in Critical Car)22.2(e)]TJ ET EMC Q endstream endobj 240 0 obj <>/ExtGState<>>> endobj 282 0 obj <>stream /P <>BDC q 1 i 0 841.89 595.276 -841.89 re 297.645 420.96 m W n .015015 841.89 595.29 -841.89 re W n /GS2 gs BT /TT2 1 Tf 9 0 0 9 369.1164 809.4926 Tm 0 0 0 1 k 0 Tc .03 Tw [(Pr)22.2(ot)15.1(ein Pr)22.2(o)30(vision in Critical Car)22.2(e )]TJ ET EMC /P <>BDC /GS1 gs BT 9 0 0 9 519.7153 809.4926 Tm 0 0 0 .5 k [(| Nutrino)30(v)30(o)]TJ ET EMC /Artifact <>BDC .068 .2 .038 .002 K 0 J 0 j 1 w 10 M [] 0 d q 1 0 0 1 401.411 785.197 cm 0 0 m 0 -734.173 l S Q EMC /P <>BDC BT /F2 1 Tf 8 0 0 8 31.1815 778.7969 Tm .34 1 .19 .01 k 0 Tw ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 37.2856 778.7969 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 778.7969 Tm .03 Tw [(If pr)25.1(ot)15.1(ein supplementa)5.1(tion impr)25.2(o)30(v)30(es )]TJ ET EMC /P <>BDC BT 8 0 0 8 32.4854 766.6969 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 766.6969 Tm .03 Tw [(mark)25.2(ers of anabolism and pr)25.1(ot)15.1(ein )]TJ ET EMC /P <>BDC BT 8 0 0 8 32.4854 754.5969 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 754.5969 Tm [(s)15.1(ynthesis.)]TJ ET EMC /P <>BDC BT 8 0 0 8 77.7083 754.5969 Tm ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 8 0 0 8 31.1815 742.4969 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 37.2856 742.4969 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 742.4969 Tm .03 Tw [(T)20(he eff)10(ect of supplemental pr)25.2(ot)15.1(ein t)15.1(o)0( )]TJ ET EMC /P <>BDC BT 8 0 0 8 32.4854 730.3969 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 730.3969 Tm .03 Tw [(achie)25.1(v)30(e)0( higher intak)25.1(es \(> 2.)20(0 g/k)25.2(g/)70.1(da)20(y\) )]TJ ET EMC /P <>BDC BT 8 0 0 8 32.4854 718.2969 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 718.2969 Tm .03 Tw [(and all-cause mortality a)5.1(t)0( v)25.2(arying da)20(y)20(s)0( )]TJ ET EMC /P <>BDC BT 8 0 0 8 32.4854 706.1969 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 706.1969 Tm (\(60-90\).)Tj ET EMC /P <>BDC BT 8 0 0 8 73.3014 706.1969 Tm ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 8 0 0 8 31.1815 694.0969 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 37.2856 694.0969 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 694.0969 Tm .03 Tw [(T)20(he influenc)15.1(e of bolus nutrition on )]TJ ET EMC /P <>BDC BT 8 0 0 8 32.4854 681.9968 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 681.9968 Tm .03 Tw [(sk)25.1(eletal muscle metabolism.)]TJ ET EMC /P <>BDC BT 8 0 0 8 149.9402 681.9968 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 8 0 0 8 31.1815 669.8968 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 37.2856 669.8968 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 669.8968 Tm .0124 Tw [(Impact of lo)25.2(w calorie)10(, lo)25.2(w pr)25.2(ot)15.1(ein f)10(eeding)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2919 669.8968 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 32.4854 657.7968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 657.7968 Tm .03 Tw [(during the acut)15.1(e phase of shock.)]TJ ET EMC /P <>BDC BT 8 0 0 8 169.3643 657.7968 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 8 0 0 8 31.1815 645.6968 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 8 0 0 8 37.2856 645.6968 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 645.6968 Tm .03 Tw [(T)20(he c)15.1(ombined appr)25.2(oach of c)15.1(ombined )]TJ ET EMC /P <>BDC BT 8 0 0 8 32.4854 633.5968 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 633.5968 Tm .03 Tw [(c)5.1(y)30(cle er)25.2(gometry and IV bolus amino )]TJ ET EMC /P <>BDC BT 8 0 0 8 32.4854 621.4968 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 39.6854 621.4968 Tm .03 Tw [(acid supplementa)5.1(tion on muscle mas)10(s.)]TJ ET EMC /P <>BDC BT 8 0 0 8 192.5884 621.4968 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 609.3568 Tm .0131 Tc .4369 Tw [(Of the RCT)115(s f)10(ocusing on pr)25.2(ot)15.2(ein dose)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2929 609.3568 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 597.2168 Tm .1329 Tw [(curr)25.1(ently r)25.2(ecruiting, it is e)25.2(vident tha)5.1(t ther)25.2(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.292 597.2168 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 206.7553 597.2168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 210.2187 597.2168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 585.0768 Tm .1964 Tw [(is s)10(till wide v)25.1(ariability in primary out)15.1(c)15.1(ome)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2919 585.0768 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 572.9368 Tm .0236 Tc .4264 Tw [(measur)25.1(es being used. F)15.1(or e)30(x)15.1(ample)10(, of)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2913 572.9368 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 209.2913 572.9368 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2913 572.9368 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 221.2913 572.9368 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 227.2912 572.9368 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 233.2912 572.9368 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 239.2912 572.9368 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 245.2912 572.9368 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 251.2912 572.9368 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 560.7968 Tm .444 Tw [(the fiv)30(e s)10(tudies in)20(v)30(e)0(s)10(tiga)5.1(ting high \(>2.)20(0)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2919 560.7968 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 548.6568 Tm .0284 Tc .5484 Tw [(g/k)25.2(g/)70.1(da)20(y\) v)30(ersus lo)25.2(w \(<1.3 g/k)25.1(g/)70.1(da)20(y\))]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 548.6568 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 536.5168 Tm .0284 Tc .5167 Tw [(pr)25.2(ot)15.1(ein doses in critically ill pa)5.1(tients,)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2915 536.5168 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 210.052 536.5168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 216.8126 536.5168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 223.5733 536.5168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 230.3337 536.5168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 237.0944 536.5168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 243.8548 536.5168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 250.6154 536.5168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 257.376 536.5168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 264.1365 536.5168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 270.8971 536.5168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 524.3768 Tm .001 Tc .449 Tw [(tw)25.1(o ar)25.1(e using mortality as the primary)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2928 524.3768 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 512.2368 Tm .0022 Tc .4478 Tw [(out)15.2(c)15.2(ome \(NCT044)40.1(7)25.2(5666, NCT0)10(316054)40.1(7\),)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2921 512.2368 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 500.0968 Tm .0284 Tc .7152 Tw [(with one using ICU length of s)10(t)0(a)20(y)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 500.0968 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 211.6404 500.0968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 487.9568 Tm .4348 Tw [(\(NCT0)10(3)5.1(5)30(7)20(3)25.1(7)20(3)5.1(9\). Another is using serum)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 487.9568 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 475.8168 Tm .0284 Tc .7782 Tw [(c)15.1(onc)15.1(entr)25.1(a)5.1(tions of tr)25.2(ans)10(th)15.1(yr)25.1(etin as a)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2915 475.8168 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 463.6768 Tm .3086 Tw [(cir)25.2(cula)5.1(ting biomark)25.2(er of nutritional s)10(t)0(a)5.1(tus)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2917 463.6768 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 451.5368 Tm .0284 Tc .6175 Tw [(and pr)25.2(ot)15.1(ein s)15.1(ynthesis \(NCT0)10(317)20(040)5.1(1\),)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 451.5368 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 439.3968 Tm .4479 Tw [(despit)15.1(e r)25.2(e)0(c)15.1(ent e)25.2(videnc)15.1(e sugges)10(ting tha)5.1(t)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 439.3968 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 209.2749 439.3968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 427.2568 Tm .3011 Tw [(this has limit)15.1(ed v)25.2(alue)10(.)]TJ ET EMC /P <>BDC BT 4 0 0 4 122.1413 430.4443 Tm 0 Tw (12)Tj ET EMC /P <>BDC BT 8 0 0 8 125.8413 427.2568 Tm .3011 Tw [( Of the fiv)30(e RCT)115(s,)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.292 427.2568 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 208.1006 427.2568 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 212.9093 427.2568 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 217.718 427.2568 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 415.1168 Tm .0284 Tc .5254 Tw [(only one has a health-r)25.1(ela)5.1(t)15.1(ed quality)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 415.1168 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 210.1218 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 216.9522 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 223.7824 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 230.6127 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 237.443 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 244.2733 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 251.1037 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 257.9339 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 264.7641 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 271.5945 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 278.4247 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 285.2551 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 292.0853 415.1168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 402.9768 Tm .0284 Tc 1.1643 Tw [(of lif)10(e primary out)15.1(c)15.1(ome measur)25.1(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2917 402.9768 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 390.8368 Tm [(\(NCT046)10(33421\).)]TJ ET EMC /P <>BDC BT 8 0 0 8 95.8294 390.8368 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 45.3547 378.6968 Tm .0131 Tc .4369 Tw [(S)15.1(yner)25.1(gis)10(tic ther)25.1(ap)25.1(y s)10(tudies tha)5.1(t use)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2902 378.6968 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 209.2902 378.6968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2902 378.6968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 221.2902 378.6968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 227.2902 378.6968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 233.2902 378.6968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 239.2902 378.6968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 245.2901 378.6968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 251.2901 378.6968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 257.2901 378.6968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 366.5568 Tm .0018 Tc .4482 Tw [(a c)15.2(ombina)5.2(tion of nutrition and ph)15.2(y)20(sical)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2923 366.5568 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 354.4168 Tm .0284 Tc .5397 Tw [(activity int)15.1(erv)30(ention with a functional)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2915 354.4168 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 342.2769 Tm .0284 Tc .8985 Tw [(primary out)15.1(c)15.1(ome ar)25.1(e seen as the)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 342.2769 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 213.1065 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 222.9213 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 232.7363 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 242.5512 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 252.3662 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 262.181 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 271.996 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 281.8109 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 291.6258 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 301.4406 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 311.2556 342.2769 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 330.1368 Tm .3042 Tw [(futur)25.2(e of critical car)25.1(e nutrition r)25.2(esear)25.2(ch.)]TJ ET EMC /P <>BDC BT 4 0 0 4 198.5118 333.3243 Tm 0 Tw (25)Tj ET EMC /P <>BDC BT 8 0 0 8 203.2919 330.1368 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 317.9969 Tm .3312 Tw [(T)20(her)25.2(e ar)25.2(e f)10(our s)10(tudies curr)25.2(ently open t)15.1(o)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 317.9969 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 305.8568 Tm .0284 Tc .542 Tw [(r)25.1(ecruitment using this dual appr)25.1(oach.)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 305.8568 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 210.2545 305.8568 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 217.2174 305.8568 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 224.1803 305.8568 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 231.143 305.8568 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 238.1059 305.8568 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 245.0688 305.8568 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 252.0315 305.8568 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 293.7168 Tm .0284 Tc 1.2049 Tw [(T)100.1(w)25.1(o ar)25.1(e using an )]TJ ET EMC /P <>BDC BT 8 0 0 8 142.2054 293.7168 Tm .0142 Tc [(ent)15.1(er)25.2(al r)25.2(out)15.1(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.1781 293.7168 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 281.5768 Tm .0048 Tc .431 Tw [(\(NCT0426)20(1543, NCT0)10(346)10(9882\))]TJ ET EMC /P <>BDC BT 8 0 0 8 160.7497 281.5768 Tm .019 Tc [( and tw)25.1(o)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2926 281.5768 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 209.2926 281.5768 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2926 281.5768 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 221.2926 281.5768 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 227.2926 281.5768 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 233.2926 281.5768 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 239.2926 281.5768 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 245.2924 281.5768 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 269.4368 Tm .0284 Tc .5399 Tw [(ar)25.1(e using boluses of IV amino acids)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 269.4368 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 257.2968 Tm -.0213 Tc -.0002 Tw [(\(NCT04099108, NCT0)10(30)10(2190)10(2\). Int)15.1(er)25.2(es)10(tingly)85.2(,)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.1213 257.2968 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 245.1568 Tm .3778 Tw [(all f)10(our ar)25.2(e using functional- or muscle-)]TJ ET EMC /P <>BDC BT 8 0 0 8 31.1815 233.0168 Tm .0284 Tc .4781 Tw [(r)25.1(ela)5.1(t)15.1(ed primary out)15.1(c)15.1(omes, but all ar)25.1(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 233.0168 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 220.8769 Tm .0284 Tc .4477 Tw [(diff)10(er)25.1(ent. Out)15.1(c)15.1(omes include change in)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 220.8769 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 208.7369 Tm .0284 Tc .4566 Tw [(muscle siz)15.1(e and depth via ultr)25.1(asound)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 208.7369 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 196.5968 Tm .0162 Tc .4338 Tw [(\(NCT0426)20.1(1543, NCT04099108\), ph)15.2(y)20.1(sical)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2926 196.5968 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 184.4568 Tm .07 Tw [(c)15.1(omponent summary thr)25.2(ee and six months)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 184.4568 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 172.3168 Tm .4327 Tw [(aft)15.1(er r)25.2(andomisa)5.1(tion \(NCT0)10(346)10(9882\) and)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 172.3168 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 209.1534 172.3168 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 160.1769 Tm .0213 Tc .8204 Tw [(six)30(-minut)15.1(e w)20(alk dis)10(tanc)15.1(e a)5.1(t)0( hospital)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2347 160.1769 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 148.0367 Tm -.0071 Tc [(dischar)25.1(ge)]TJ ET EMC /P <>BDC BT 8 0 0 8 68.9334 148.0367 Tm 0 Tc .03 Tw [( \(NCT0)10(30)10(2190)10(2\).)]TJ ET EMC /P <>BDC BT 8 0 0 8 136.6372 148.0367 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 45.3547 135.8968 Tm .0284 Tc 1.0223 Tw [(T)135(o)0( o)30(v)30(e)0(r)25.1(c)15.1(ome the challenges in)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 135.8968 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 123.7569 Tm .0284 Tc .8743 Tw [(det)15.1(ermining appr)25.1(opria)5.1(t)15.1(e)0( and pa)5.1(tient)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 123.7569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 111.6169 Tm .004 Tc .446 Tw [(c)15.2(entr)25.2(ed out)15.2(c)15.2(omes f)10.1(or nutrition r)25.2(esear)25.2(ch)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.293 111.6169 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 209.293 111.6169 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.293 111.6169 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 221.293 111.6169 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 227.293 111.6169 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 233.293 111.6169 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 239.293 111.6169 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 245.2929 111.6169 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 251.2929 111.6169 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 257.2929 111.6169 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 99.4767 Tm .1934 Tw [(in critical car)25.2(e)10(,)0( a c)15.1(o)0(r)25.2(e)0( out)15.1(c)15.1(ome set \()30(C)20(O)5.1(S)0(\))]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2917 99.4767 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 87.3368 Tm .0931 Tw [(has been pr)25.2(oposed in line with other ar)25.2(eas)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2917 87.3368 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 75.1968 Tm .03 Tw [(of critical car)25.1(e r)25.2(esear)25.2(ch.)]TJ ET EMC /P <>BDC BT 4 0 0 4 125.274 78.3843 Tm 0 Tw (14)Tj ET EMC /P <>BDC BT 8 0 0 8 129.27 75.1968 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 131.91 75.1968 Tm ( )Tj ET EMC /P <>BDC BT /TT4 1 Tf 8 0 0 8 45.3547 63.1968 Tm .0284 Tc .448 Tw [(A core outcome set is an agreed)]TJ ET EMC /P <>BDC BT 8 0 0 8 203.2916 63.1968 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 31.1815 51.1968 Tm .226 Tw (standardised set of outcomes that should)Tj ET EMC /P <>BDC BT 8 0 0 8 203.2919 51.1968 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 779.3569 Tm .1386 Tw (be measured and reported, as a minimum,)Tj ET EMC /P <>BDC BT 8 0 0 8 387.4019 779.3569 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 390.9107 779.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 394.4197 779.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 397.9288 779.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 767.3569 Tm .0382 Tw (in all clinical trials in specific areas of health)Tj ET EMC /P <>BDC BT 8 0 0 8 387.402 767.3569 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 755.3569 Tm .03 Tw (or healthcare.)Tj ET EMC /P <>BDC BT 4 0 0 4 270.9076 758.2631 Tm 0 Tw (26)Tj ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 275.8197 755.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 229.465 743.3569 Tm .0284 Tc .5357 Tw [(As discus)10(sed in this r)25.2(e)25.1(vie)25.1(w)70.1(,)0( ther)25.2(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 743.3569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 394.315 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 401.2281 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 408.1414 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 415.0546 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 421.9676 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 428.8809 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 435.7941 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 442.7071 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 449.6203 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 456.5336 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 463.4466 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 470.3598 743.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 731.3569 Tm .0284 Tc .7684 Tw [(is a wide and v)25.1(aried spectrum of)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4017 731.3569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 396.1765 731.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 404.9513 731.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 413.7259 731.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 719.3569 Tm .0284 Tc 1.1701 Tw [(objectiv)30(es and out)15.1(c)15.1(omes of RCT)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 719.3569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 399.3903 719.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 411.3787 719.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 423.3671 719.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 435.3555 719.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 707.3569 Tm .0284 Tc .8914 Tw [(as)10(ses)10(sing nutritional int)15.1(erv)30(entions in)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 707.3569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 695.3569 Tm .3217 Tw [(critically ill pa)5.1(tients and the use of C)20(O)5.1(S)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 695.3569 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 392.3759 695.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 397.3495 695.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 402.3233 695.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 407.2972 695.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 412.2709 695.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 417.2447 695.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 683.3569 Tm .0861 Tw [(ma)20(y help t)15.1(o)0( c)15.1(ompar)25.2(e nutritional s)10(t)0(r)25.2(a)5.1(t)15.1(egies,)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 683.3569 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 671.3569 Tm .0284 Tc .8366 Tw [(eff)10(ectiv)30(ely pool da)5.1(ta fr)25.2(om diff)10(er)25.1(ent)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 671.3569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 396.7218 671.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 406.0418 671.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 415.3618 671.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 424.6819 671.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 434.0018 671.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 659.3569 Tm .0284 Tc .6868 Tw [(s)10(tudies on the same c)15.1(ondition, and)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 659.3569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 647.3569 Tm .0185 Tc .4315 Tw [(enc)15.1(our)25.1(age mor)25.2(e c)15.1(omplet)15.1(e r)25.1(eporting of)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4016 647.3569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 635.3569 Tm .0284 Tc .8972 Tw [(out)15.1(c)15.1(omes. T)20(his will also allo)25.1(w f)10(o)0(r)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 635.3569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 623.3569 Tm .0284 Tc .7506 Tw [(c)15.1(omparison betw)25.1(een s)10(tudies and t)15.1(o)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 623.3569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 611.3569 Tm .1937 Tw [(c)15.1(onduct meta-analy)20(ses.)]TJ ET EMC /P <>BDC BT 4 0 0 4 310.0882 614.5444 Tm (11, 14)Tj ET EMC /P <>BDC BT 8 0 0 8 319.6591 611.3569 Tm [( W)65.2(ork is alr)25.2(eady)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 611.3569 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.3518 611.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 395.3016 611.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 599.3569 Tm .0267 Tc .4233 Tw [(in pr)25.1(ogr)25.1(es)10(s with int)15.1(erna)5.1(tional nutrition)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4007 599.3569 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 587.3569 Tm .3293 Tw [(e)30(xperts, t)15.1(o)0( de)25.2(v)30(elop critical car)25.2(e nutrition)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 587.3569 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 575.3569 Tm -.02 Tc [(CO)-14.9(S)-20(.)]TJ ET EMC /P <>BDC BT 4 0 0 4 234.7545 578.5444 Tm -.0152 Tc (27)Tj ET EMC /P <>BDC BT 8 0 0 8 239.402 575.3569 Tm 0 Tc .1012 Tw [( T)20(his s)10(tudy will e)30(xpand on out)15.1(c)15.1(omes)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 575.3569 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 563.3569 Tm .3915 Tw [(initially identified in a s)15.1(y)20(s)10(t)15.1(ema)5.1(tic r)25.2(e)25.2(vie)25.1(w)70.1(,)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4021 563.3569 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 392.9344 563.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 398.4668 563.3569 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 551.3569 Tm .2404 Tw [(and include further r)25.2(esear)25.2(ch fr)25.2(om A)10(ugus)10(t)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 551.3569 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 539.3569 Tm .03 Tw [(20)5.1(18 t)15.1(o)0( pr)25.2(esent da)20(y)85.2(.)]TJ ET EMC /P <>BDC BT 4 0 0 4 294.7665 542.5444 Tm 0 Tw (14)Tj ET EMC /P <>BDC BT 8 0 0 8 298.7626 539.3569 Tm ( )Tj ET EMC /P <>BDC /GS1 gs BT /TT2 1 Tf 12 0 0 12 215.2917 518.6876 Tm .34 1 .19 .01 k [(C)10(onclusion)]TJ ET EMC /P <>BDC BT 12 0 0 12 280.8476 518.6876 Tm .27 .93 .68 .19 k ( )Tj ET EMC /P <>BDC /GS2 gs BT 8 0 0 8 215.2917 503.303 Tm 0 0 0 1 k .0286 Tc .5516 Tw [(Wher)22.2(e does all tha)5.1(t lea)20(v)30(e)0( us)35.2(? Mor)22.2(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 503.303 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 490.753 Tm .0286 Tc .7096 Tw [(ques)10(tions than ans)15.1(w)25.2(ers, ma)20(ybe)10(, but)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 490.753 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 478.2029 Tm .0286 Tc .6963 Tw [(absenc)15.1(e of r)22.2(obus)10(t RCT e)25.2(videnc)15.1(e is)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4017 478.2029 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 395.6006 478.2029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 403.7997 478.2029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 465.6529 Tm .1184 Tw [(c)15.1(ertainly not e)25.2(videnc)15.1(e of absenc)15.1(e)10(,)0( and w)25.2(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4017 465.6529 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 453.1029 Tm .3157 Tw [(ar)22.2(e hopeful tha)5.1(t lar)21(ge int)15.1(erna)5.1(tional trials)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4021 453.1029 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 440.553 Tm .2042 Tw [(will help t)15.1(o)0( shed light on optimal pr)22.2(ot)15.1(ein)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4017 440.553 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.4351 440.553 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 395.4686 440.553 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 428.0029 Tm .0979 Tw [(dosing in diff)10(er)22.2(ent s)10(tages of a critical car)22.2(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4017 428.0029 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 415.4529 Tm [(admis)10(sion.)]TJ ET EMC /P <>BDC BT 8 0 0 8 256.9956 415.4529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 229.465 402.9029 Tm .0692 Tw [(In the meantime)10(, the r)22.2(e)0(c)15.1(ommenda)5.1(tions)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 402.9029 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 390.3529 Tm .0065 Tc .4435 Tw [(in major guidelines of 1.2-2.)20(0 g/k)25.1(g)0(/)70(d)0(a)20(y)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4017 390.3529 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 377.8029 Tm .2028 Tw [(r)22.2(emain appr)22.2(opria)5.1(t)15.1(e)0( f)10(or use in the gener)25.2(al)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4017 377.8029 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 365.2529 Tm -.0401 Tw [(ICU pa)5.1(tient, with the mos)10(t r)22.2(e)0(c)15.1(ently upda)5.1(t)15.1(e)0(d)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 365.2529 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 352.7029 Tm .2628 Tw [(of these)10(, ESPEN, s)10(tipula)5.1(ting 1.3 g/k)25.2(g/)70.1(da)20(y)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 352.7029 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.9045 352.7029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 396.4073 352.7029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.9099 352.7029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 340.153 Tm .03 Tw [(as the r)22.2(e)0(c)15.1(ommended tar)21(get.)]TJ ET EMC /P <>BDC BT 4 0 0 4 328.5529 343.0592 Tm (6, 7)Tj ET EMC /P <>BDC BT 8 0 0 8 335.825 340.153 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 229.465 327.6028 Tm .1254 Tw [(W)15.1(ith curr)22.2(ent pr)22.2(ot)15.1(ein r)22.2(e)0(c)15.1(ommenda)5.1(tions)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 327.6028 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 315.0529 Tm .0093 Tc .4407 Tw [(acr)22.2(os)10(s all clinical gr)22.2(oups based almos)10(t)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4031 315.0529 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 302.5029 Tm .0745 Tw [(e)30(x)35.2(clusiv)30(ely on observ)25.2(a)5.1(tional da)5.1(ta, w)25.2(e)0( mus)10(t)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 302.5029 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 289.9529 Tm .2363 Tw [(hope and aim f)10(or high quality RCT)108.2(s with)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 289.9529 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 391.6921 289.9529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 395.9825 289.9529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.2726 289.9529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 404.5628 289.9529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 408.853 289.9529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 413.1432 289.9529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 417.4335 289.9529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 277.4029 Tm .236 Tw [(a good le)25.1(v)30(el of homogeneity in t)15.1(erms of)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 277.4029 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 264.8529 Tm .0611 Tw [(s)10(tudy design, wher)22.2(e pr)22.2(ot)15.1(ein is in)20(v)30(e)0(s)10(tiga)5.1(t)15.1(e)0(d)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4021 264.8529 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 252.3029 Tm .3104 Tw [(in isola)5.1(tion r)25.2(a)5.1(ther than alongside ener)21(gy)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 252.3029 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 239.7529 Tm .0286 Tc .4536 Tw [(dose)10(, and crucially)85.2(, with longer t)15.1(erm,)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 239.7529 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 227.2029 Tm .0257 Tc .4243 Tw [(r)22.3(ele)25.2(v)25.2(ant, muscle-r)22.3(ela)5.2(t)15.2(ed and functional)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4017 227.2029 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 214.6529 Tm .0286 Tc .5387 Tw [(out)15.1(c)15.1(omes r)22.2(outinely measur)22.2(ed. T)15.1(his is)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 214.6529 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 202.1029 Tm .4189 Tw [(es)10(sential, as ICU surviv)25.2(al r)25.1(a)5.1(t)15.1(es c)15.1(ontinue)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 202.1029 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 393.1531 202.1029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 398.9043 202.1029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 404.6554 202.1029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 410.4066 202.1029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 416.1578 202.1029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 421.9089 202.1029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 427.6601 202.1029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 189.5529 Tm .03 Tw [(t)15.1(o)0( impr)22.2(o)30(v)30(e)10(.)]TJ ET EMC /P <>BDC BT 8 0 0 8 260.2963 189.5529 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 229.465 177.0028 Tm .0286 Tc .603 Tw [(Finally)85.2(, but crucially)85.2(, w)25.1(e)0( need t)15.1(o)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 177.0028 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 164.4529 Tm .3014 Tw [(ackno)25.2(wledge tha)5.1(t setting pr)22.2(ot)15.1(ein tar)21(gets)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4021 164.4529 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 151.9029 Tm .0286 Tc .4606 Tw [(ar)22.2(e one thing, but achie)25.1(ving them is)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 151.9029 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 139.3528 Tm .0286 Tc .6473 Tw [(another)90.1(, and man)15.1(y of these s)10(tudies)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 139.3528 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 126.8029 Tm .0286 Tc .5051 Tw [(demons)10(tr)25.2(a)5.1(t)15.1(e this all t)15.1(oo clearly)85.2(, with)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 126.8029 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 394.0715 126.8029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.7411 126.8029 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 114.2527 Tm .3939 Tw [(pr)22.2(ot)15.1(ein deliv)30(ery oft)15.1(en f)15.1(alling w)25.1(ell belo)25.2(w)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4021 114.2527 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 392.9536 114.2527 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 398.5052 114.2527 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 404.0568 114.2527 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 409.6084 114.2527 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 101.7029 Tm .0286 Tc 1.0436 Tw [(the le)25.1(v)30(els r)22.2(e)0(c)15.1(ommended in major)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.402 101.7029 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 89.1529 Tm .0286 Tc .4746 Tw [(guidelines. T)15.1(his limits the c)15.1(onclusions)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4019 89.1529 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 393.8274 89.1529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 400.253 89.1529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 406.6787 89.1529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 413.1044 89.1529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 419.5299 89.1529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 425.9555 89.1529 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 76.6028 Tm .0113 Tc .4387 Tw [(tha)5.1(t can be dr)25.2(a)20(wn fr)22.2(om them. As w)25.2(e)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4029 76.6028 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 393.4029 76.6028 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 399.4029 76.6028 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 405.4029 76.6028 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 411.4029 76.6028 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 417.4029 76.6028 Tm ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 64.0528 Tm .0673 Tw [(kno)25.2(w)70.1(,)0( pr)22.2(escription does not equal deliv)30(ery)85.2(,)]TJ ET EMC /P <>BDC BT 8 0 0 8 387.4021 64.0528 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 8 0 0 8 215.2917 51.5028 Tm .03 Tw [(but tha)5.1(t is a t)15.1(opic f)10(or another article)10(.)]TJ ET EMC /P <>BDC BT /F1 1 Tf 8 0 0 8 362.8335 51.5028 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 604.456 Tm [(R)10(e)0(f)10(e)0(r)25.1(enc)15.1(es: )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 445.491 604.456 Tm (1.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 448.506 604.456 Tm -.0377 Tw [( Da)20(vies ML et al. \(20)5.1(17\) Pr)25.2(ot)15.1(ein deliv)30(ery and clinical)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 604.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 597.456 Tm .2698 Tw [(out)15.1(c)15.1(omes in the critically ill: a s)15.1(y)20(s)10(t)15.1(ema)5.1(tic r)25.1(e)25.1(vie)25.1(w and meta-)]TJ ET EMC /P <>BDC BT 5 0 0 5 415.7711 590.456 Tm .0984 Tw [(analy)20(sis. Crit Car)25.1(e R)10(esusc. 19 \(2\):117)30(-)30(1)0(2)15.1(7)100.1(. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 518.2792 590.456 Tm 0 Tw (2.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 522.4993 590.456 Tm .0984 Tw [( F)15.1(ett)15.1(erplac)15.1(e K et al.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 590.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 583.456 Tm .008 Tc .442 Tw [(\(20)10(20\) S)15.1(y)20(s)10(t)15.1(ema)5.1(tic R)10(e)25.1(vie)25.1(w W)15.1(ith Meta-)40(Analy)20(sis of P)10(a)5.1(tient-)]TJ ET EMC /P <>BDC BT 5 0 0 5 415.7711 576.456 Tm .0284 Tc .5456 Tw [(C)10(ent)15.1(er)25.2(ed Out)15.1(c)15.1(omes, C)10(omparing Int)15.1(erna)5.1(tional Guideline-)]TJ ET EMC /P <>BDC BT 5 0 0 5 415.7711 569.456 Tm 0 Tc .3827 Tw [(R)10(e)0(c)15.1(ommended Ent)15.1(er)25.1(al Pr)25.1(ot)15.1(ein Deliv)30(ery W)15.1(ith Usual Car)25.1(e)10(.)0( J)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 569.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 562.456 Tm .1229 Tw [(P)10(a)0(r)25.1(ent)15.1(er Ent)15.1(er)25.1(al Nutr)90.1(.; 44\(4\):6)20(10-620 )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 510.8018 562.456 Tm 0 Tw (3.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 515.0919 562.456 Tm .123 Tw [( Puthucheary ZA et al.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3111 562.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 555.456 Tm .1368 Tw [(\(20)10(20\) A)25.1(cut)15.1(e sk)25.1(eletal muscle w)20(a)0(s)10(ting in critical illnes)10(s. J)25.1(AMA.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 555.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 548.456 Tm [(16;310\(15\):15)5.1(91-600)20(. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 466.1367 548.456 Tm (4.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 470.7167 548.456 Tm .2692 Tw [( Lad H, Saumur TM, Herridge MS, Dos)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 548.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 541.456 Tm .1982 Tw [(Sant)15.1(os C)20(C, Ma)5.1(thur S, Ba)5.1(tt J)15.2(,)0( Gilbert PM. Int)15.1(ensiv)30(e Car)25.1(e Unit-)]TJ ET EMC /P <>BDC BT 5 0 0 5 415.7711 534.456 Tm .0135 Tc .4365 Tw [(A)25.1(c)10(quir)25.1(ed W)65.2(eaknes)10(s: Not jus)10(t Another Muscle A)30(t)0(r)25.1(oph)15.1(ying)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3114 534.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 527.456 Tm .2562 Tw [(C)10(ondition. Int J Mol Sci. 22;21\(21\):7)10(840 )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 518.7369 527.456 Tm 0 Tw (5.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 523.0219 527.456 Tm .2562 Tw [( Schef)10(old JC et al.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 527.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 520.456 Tm .0804 Tw [(\(20)10(20\) Muscular w)25.1(eaknes)10(s and muscle w)20(a)0(s)10(ting in the critically)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3111 520.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 513.456 Tm .0365 Tw [(ill. J Cache)30(xia Sar)25.1(c)15.1(openia Muscle)10(.; 11\(6\):13)5.1(99-)30(14)20(12 )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 536.8322 513.456 Tm 0 Tw (6.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 541.2922 513.456 Tm .0365 Tw [( McCla)20(v)30(e)0( S)15.1(A)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 513.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 506.456 Tm .0047 Tw [(et al. \(20)5.1(16\) Society of Critical Car)25.1(e Medicine; American Society)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 506.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 499.456 Tm .0138 Tw [(f)10(or P)10(a)0(r)25.1(ent)15.1(er)25.1(al and Ent)15.1(er)25.1(al Nutrition. Guidelines f)10(or the Pr)25.1(o)30(vision)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 499.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 573.8801 499.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 575.4495 499.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 577.0187 499.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 492.456 Tm .3324 Tw [(and As)10(ses)10(sment of Nutrition Support T)20(her)25.1(ap)25.1(y in the A)25.1(dult)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 492.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 485.456 Tm .1974 Tw [(Critically Ill P)10(a)5.1(tient: Society of Critical Car)25.1(e Medicine \(SC)20(CM\))]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 485.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 478.456 Tm .4205 Tw [(and American Society f)10(or P)10(a)0(r)25.1(ent)15.1(er)25.1(al and Ent)15.1(er)25.1(al Nutrition)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3111 478.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 471.456 Tm .1702 Tw [(\(A.S.P)100.1(.E.N.\). J P)10(a)0(r)25.1(ent)15.1(er Ent)15.1(er)25.1(al Nutr)90.1(.; 40\(2\):15)5.1(9-211. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 544.834 471.456 Tm -.1001 Tc 0 Tw (7.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 548.5385 471.456 Tm 0 Tc .1702 Tw [( Singer P)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 471.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 574.6622 471.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 577.0133 471.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 579.3647 471.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 581.7159 471.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 464.456 Tm .006 Tc .444 Tw [(et al. \(20)5.1(18\) ESPEN guideline on clinical nutrition in the)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 464.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 576.061 464.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 579.811 464.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 457.456 Tm .2533 Tw [(int)15.1(ensiv)30(e car)25.1(e unit. Clin Nutr)90.1(.; 38\(1\):48-)40(7)15.1(9)10(. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 526.0579 457.456 Tm 0 Tw (8.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 530.4329 457.456 Tm .2533 Tw [( C)10(omposition of)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3111 457.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 450.456 Tm .0076 Tc .4424 Tw [(Ent)15.1(er)25.1(al Nutrition: High Pr)25.1(ot)15.1(ein v)20(s. L)10(o)25.1(w Pr)25.1(ot)15.1(ein [Int)15.1(ernet].)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3094 450.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 443.456 Tm .1088 Tw [(Criticalcar)25.2(enutrition.)20(c)15.1(om. 20)10(21 [)20(cit)15.1(ed 8 A)10(ugus)10(t 20)10(21]. A)60.1(v)25.1(ailable)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 443.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 436.456 Tm .1059 Tw [(fr)25.1(om: w)10(w)10(w)70.1(.)20(criticalcar)25.1(enutrition.)20(c)15.1(om/)70.1(docs/)85.2(s)15.1(y)20(s)10(t)15.1(ema)5.1(tic _r)25.1(e)25.1(vie)25.1(w)15.1(s)0(_)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 436.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 429.456 Tm .0068 Tc [(20)5.1(18/)95.2(4.2c%20High%20pr)25.2(ot)15.2(ein_20)5.1(18.pdf )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 518.344 429.456 Tm -.0032 Tc (9.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 522.8222 429.456 Tm .0068 Tc .4432 Tw [( Zusman O et al.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3102 429.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 422.456 Tm .0284 Tc .5099 Tw [(\(20)5.1(16\) R)10(e)0(s)10(ting ener)25.2(gy e)30(xpenditur)25.2(e)10(,)0( calorie and pr)25.1(ot)15.1(ein)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3111 422.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 415.456 Tm .366 Tw [(c)15.1(onsumption in critically ill pa)5.1(tients: a r)25.2(etr)25.1(ospectiv)30(e c)15.1(ohort)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3107 415.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 408.456 Tm .1738 Tw [(s)10(tudy)85.2(. Crit Car)25.1(e)10(.)0( 20)5.1(16; 20\(1\):36)25.1(7)100.1(.)0( )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 499.422 408.456 Tm 0 Tw [(10)20(.)]TJ ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 505.9118 408.456 Tm .1738 Tw [( Fiac)15.1(cadori E et al. \(20)10(21\))]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3107 408.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 401.456 Tm .258 Tw [(ESPEN guideline on clinical nutrition in hospitaliz)15.1(ed pa)5.1(tients)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 401.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 394.456 Tm .2549 Tw [(with acut)15.1(e or chr)25.1(onic kidne)25.1(y disease)10(. Clin Nutr)90.1(.; 40\(4\):1644-)]TJ ET EMC /P <>BDC BT 5 0 0 5 415.7711 387.456 Tm 0 Tw (1668. )Tj ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 430.019 387.456 Tm (11.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 434.8241 387.456 Tm .0706 Tw [( Ar)25.1(abi YM, Pr)25.1(eiser JC. \(20)5.1(17\) A critical vie)25.1(w on primary)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 387.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 380.456 Tm .1738 Tw [(and sec)15.1(ondary out)15.1(c)15.1(ome measur)25.1(es in nutrition trials. Int)15.1(ensiv)30(e)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 380.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 373.456 Tm .11 Tw [(Car)25.1(e Medicine)10(. 20)5.1(17 Dec;43\(12\):18)10(7)25.1(5)0(-)30(1)0(8)10(7)0(7)100.1(.)0( )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 520.5722 373.456 Tm 0 Tw (12.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 526.5823 373.456 Tm .11 Tw [( De W)70.1(aele E et al.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3106 373.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 366.456 Tm .0067 Tc .4433 Tw [(\(20)10(21\) R)10(e)25.1(vie)25.1(w)0( of e)25.1(v)30(olution and curr)25.1(ent s)10(t)-.1(a)5.1(t)0(us of pr)25.1(ot)15.1(ein)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3121 366.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 359.456 Tm .2688 Tw [(r)25.1(equir)25.1(ements and pr)25.1(o)30(vision in acut)15.1(e illnes)10(s and critical car)25.1(e)10(.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 359.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 575.1552 359.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 577.9994 359.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 580.8436 359.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 352.4561 Tm .3722 Tw [(Clin Nutr)90.1(. 20)10(21;40\(5\):29)5.1(58-29)25.1(7)20(3)0( )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 500.7521 352.4561 Tm 0 Tw (13.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 506.832 352.4561 Tm .3722 Tw [( Bear D)40(,)0( Puthucheary Z.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3107 352.4561 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 345.456 Tm .3077 Tw [(\(20)5.1(19\) Designing nutrition-based int)15.1(erv)30(entional trials f)10(or the)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 345.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 338.456 Tm .0534 Tw [(futur)25.1(e: addr)25.1(es)10(sing the unkno)25.1(wns. Crit Car)25.1(e; 23\(1\). )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 539.5428 338.456 Tm 0 Tw (14.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 545.9128 338.456 Tm .0534 Tw [( T)135(a)20(v)30(ern)15.1(y G)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 338.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 331.4561 Tm .112 Tw [(et al. \(20)5.1(19\) Out)15.1(c)15.1(omes used in r)25.1(andomised c)15.1(ontr)25.1(olled trials of)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3111 331.4561 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 324.456 Tm .0498 Tw [(nutrition in the critically ill: a s)15.1(y)20(s)10(t)15.1(ema)5.1(tic r)25.1(e)25.1(vie)25.1(w)70.1(.)0( Crit Car)25.1(e; 23\(1\).)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3107 324.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 415.7711 317.456 Tm (15.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 421.8461 317.456 Tm .4161 Tw [( Hoff)10(er L et al. \(20)5.1(17\) W)15.1(ill W)65.2(e)0( E)10(v)30(er A)25.1(g)0(r)25.1(ee on Pr)25.1(ot)15.1(ein)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 317.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 310.4561 Tm .2043 Tw [(R)10(equir)25.1(ements in the Int)15.1(ensiv)30(e Car)25.1(e Unit? Nutr Clin Pr)25.1(act.; 32)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 310.4561 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 574.8324 310.4561 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 577.3538 310.4561 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 579.8752 310.4561 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 582.3967 310.4561 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 584.9181 310.4561 Tm ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 415.7711 303.456 Tm (16.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 422.0211 303.456 Tm .0781 Tw [( W)65.2(eijs, P Jet al. \(20)5.1(12\). Optimal pr)25.1(ot)15.1(ein and ener)25.1(gy nutrition)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3106 303.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 296.456 Tm .0048 Tc .4452 Tw [(decr)25.2(eases mortality in mechanically v)30.1(entila)5.2(t)15.2(ed, critically ill)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3112 296.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 289.4561 Tm .165 Tw [(pa)5.1(tients: a pr)25.2(ospectiv)30(e observ)25.1(a)5.1(tional c)15.1(ohort s)10(tudy)85.2(. J P)10(a)0(r)25.1(ent)15.1(er)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3107 289.4561 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 282.456 Tm -.0231 Tw [(Ent)15.1(er Nutr)90.1(, 36\(1\), 6068. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 476.5771 282.456 Tm 0 Tw [(17)100.1(.)]TJ ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 482.0717 282.456 Tm -.0231 Tw [( Allings)10(trup MJ et al. \(20)5.1(12\) Pr)25.1(o)30(vision)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3107 282.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 275.456 Tm .1221 Tw [(of pr)25.1(ot)15.1(ein and ener)25.1(gy in r)25.1(ela)5.1(tion t)15.1(o)0( measur)25.1(ed r)25.1(equir)25.2(ements in)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 275.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 268.4561 Tm .1801 Tw [(int)15.1(ensiv)30(e car)25.1(e pa)5.1(tients. Clin Nutr)90.1(.; 31\(4\):462-468. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 541.3859 268.4561 Tm 0 Tw (18.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 547.5509 268.4561 Tm .1801 Tw [( Nic)15.1(olo M)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 268.4561 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 574.7113 268.4561 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 577.1117 268.4561 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 579.5121 268.4561 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 581.9126 268.4561 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 584.313 268.4561 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 261.456 Tm .1543 Tw [(et al. \(20)5.1(16\) Clinical out)15.1(c)15.1(omes r)25.1(ela)5.1(t)15.1(ed t)15.1(o)0( pr)25.1(ot)15.1(ein deliv)30(ery in a)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3107 261.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 254.456 Tm .1088 Tw [(critically ill popula)5.1(tion: a multic)15.1(ent)15.1(er)90.1(, multina)5.1(tional observ)25.1(a)5.1(tion)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 254.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 247.456 Tm .0825 Tw [(s)10(tudy)85.2(. J P)10(a)0(r)25.1(ent)15.1(er Ent)15.1(er)25.1(al Nutr 20)5.1(16;40:45. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 521.7061 247.456 Tm 0 Tw [(19)10(.)]TJ ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 527.9061 247.456 Tm .0825 Tw [( C)10(ompher C et al.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3107 247.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 240.456 Tm .2358 Tw [(\(20)5.1(17\) Gr)25.1(ea)5.1(t)15.1(er pr)25.1(ot)15.1(ein and ener)25.1(gy intak)25.1(e ma)20(y be as)10(socia)5.1(t)15.2(e)0(d)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 240.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 233.456 Tm .2304 Tw [(with impr)25.1(o)30(v)30(ed mortality in higher risk critically ill pa)5.1(tients: a)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 233.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 226.456 Tm .0597 Tw [(pa)5.1(tient multic)15.1(ent)15.1(er)90.1(, multina)5.1(tional observ)25.1(a)5.1(tional s)10(tudy)85.2(. Crit Car)25.1(e)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 226.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 219.456 Tm .2518 Tw [(Med 20)5.1(17;45:156. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 460.7385 219.456 Tm 0 Tw [(20)20(.)]TJ ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 468.4335 219.456 Tm .2518 Tw [( Allings)10(trup MJ et al. \(20)5.1(17\) Early goal-)]TJ ET EMC /P <>BDC BT 5 0 0 5 415.7711 212.456 Tm -.0018 Tw [(dir)25.1(ect)15.1(ed nutrition v)30(ersus s)10(tandar)25.1(d of car)25.2(e in adult int)15.1(ensiv)30(e car)25.1(e)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3107 212.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 205.456 Tm .4233 Tw [(pa)5.1(tients: the single c)15.1(entr)25.1(e)10(,)0( r)25.1(andomised, out)15.1(c)15.1(ome as)10(ses)10(sor-)]TJ ET EMC /P <>BDC BT 5 0 0 5 415.7711 198.456 Tm .0284 Tc .5458 Tw [(blinded EA)90.1(T)90.1(-ICU trial. Int)15.1(ensiv)30(e Car)25.2(e Med 20)5.1(17;43:16)10(3)25.2(7)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3114 198.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 576.6823 198.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 581.0533 198.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 585.4243 198.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 589.7952 198.456 Tm ( )Tj ET EMC /P <>BDC BT 5 0 0 5 594.1662 198.456 Tm ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 415.7711 191.456 Tm .0286 Tc (21.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 422.21 191.456 Tm .0284 Tc .4333 Tw [( W)15.1(ischme)25.2(y)30(er PE et al. \(20)5.1(17\) A r)25.2(andomiz)15.1(ed trial of)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3111 191.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 184.456 Tm .0284 Tc .7311 Tw [(supplemental par)25.2(ent)15.1(er)25.2(al nutrition in underw)25.2(eight and)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3111 184.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 177.456 Tm .0177 Tw [(o)30(v)30(erw)25.1(eight critically ill pa)5.1(tients: the T)55.2(OP-UP pilot trial. Crit Car)25.1(e)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 177.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 170.456 Tm [(20)5.1(17;21:142. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 444.6253 170.456 Tm (22.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 451.8405 170.456 Tm .03 Tw [( F)15.1(errie S et al. \(20)5.1(16\) Pr)25.1(ot)15.1(ein r)25.1(equir)25.1(ements in the)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3107 170.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 163.456 Tm .002 Tc .448 Tw [(critically ill: a r)25.1(andomiz)15.1(ed c)15.1(ontr)25.1(olled trial using par)25.1(ent)15.1(er)25.1(al)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3106 163.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 156.456 Tm .3514 Tw [(nutrition. J P)10(a)0(r)25.1(ent)15.1(er Ent)15.1(er)25.1(al Nutr 20)5.1(16;40:7)15.1(9)5.1(5)0( )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 538.9194 156.456 Tm 0 Tw (23.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 546.2044 156.456 Tm .3514 Tw [( L)10(ooijaar)25.1(d)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 156.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 149.456 Tm .1197 Tw [(W)35.2(GPM et al. \(20)10(20\) Early high pr)25.1(ot)15.1(ein intak)25.1(e and mortality in)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 149.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 142.456 Tm .2371 Tw [(critically ill ICU pa)5.1(tients with lo)25.1(w sk)25.1(eletal muscle ar)25.1(ea and -)]TJ ET EMC /P <>BDC BT 5 0 0 5 415.7711 135.456 Tm .0933 Tw [(density)85.2(. Clin Nutr)90.1(. Jul; 3)5.1(9\(7\): 219)10(2-220)5.1(1. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 515.1575 135.456 Tm -.0261 Tc 0 Tw [(24)-26.1(.)]TJ ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 522.6019 135.456 Tm 0 Tc .0933 Tw [( F)15.1(ett)15.2(erplac)15.2(e K et al.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 135.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 128.456 Tm .0719 Tw [(\(20)5.1(18\) T)135(a)0(r)25.1(get)15.1(ed Full Ener)25.1(gy and Pr)25.1(ot)15.1(ein Deliv)30(ery in Critically Ill)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3111 128.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 121.456 Tm .2393 Tw [(P)10(a)5.1(tients: A Pilot Randomiz)15.1(ed C)10(ontr)25.1(olled T)100.1(rial \(FEED T)100.1(rial\). J)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 121.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 114.456 Tm .3317 Tw [(P)10(a)0(r)25.1(ent)15.1(er Ent)15.1(er)25.1(al Nutr)90.1(.; 42\(8\):125)10(2-)30(1262. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 518.7266 114.456 Tm 0 Tw (25.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 526.0067 114.456 Tm .3317 Tw [( Chapple L et al.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 114.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 107.456 Tm .0284 Tc .7632 Tw [(\(20)10(20\) Out)15.1(c)15.1(ome Measur)25.2(es in Critical Car)25.1(e Nutrition)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3111 107.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 100.456 Tm .4272 Tw [(Int)15.1(erv)30(entional T)100.1(rials: A S)15.1(y)20(s)10(t)15.1(ema)5.1(tic R)10(e)25.1(vie)25.1(w)70.1(.)0( Nutr Clin Pr)25.1(act.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 100.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 93.456 Tm .0103 Tc .4397 Tw [(20)10(20;3)5.1(5\(3\): 506-513. )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 473.722 93.456 Tm 0 Tw (26.)Tj ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 481.3323 93.456 Tm .4397 Tw [( C)20(OMET Initia)5.2(tiv)30(e \(20)10(21\) | Home)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3116 93.456 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 86.456 Tm .4173 Tw [([Int)15.1(ernet]. C)10(omet-initia)5.1(tiv)30(e)10(.)20(or)25.1(g. 20)10(21 [)20(cit)15.1(ed 8 A)10(ugus)10(t 20)10(21].)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 86.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 79.456 Tm .2677 Tw [(A)25.1(c)15.1(c)15.1(e)0(s)10(sed fr)25.1(om: w)10(w)10(w)70.1(.)20(c)15.1(omet-initia)5.1(tiv)30(e)10(.)20(or)25.1(g/ )]TJ ET EMC /P <>BDC BT /TT2 1 Tf 5 0 0 5 524.2206 79.456 Tm -.0122 Tc 0 Tw [(27)87.9(.)]TJ ET EMC /P <>BDC BT /F1 1 Tf 5 0 0 5 530.8589 79.456 Tm 0 Tc .2677 Tw [( Puthucheary Z.)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 79.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 72.456 Tm .1042 Tw [(\(20)10(21\) C)10(o)0(r)25.1(e)0( Out)15.1(c)15.1(ome Measur)25.1(es f)10(or Clinical Eff)10(ectiv)30(enes)10(s T)100.1(rials)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.311 72.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 65.456 Tm .0994 Tw [(of Nutritional and Metabolic Int)15.1(erv)30(entions in Critical Illnes)10(s: An)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 65.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 58.456 Tm -.0197 Tw [(Int)15.1(erna)5.1(tional Modified Delphi C)10(onsensus S)5.1(tudy A)25.1(c)15.1(c)15.1(e)0(s)10(sed online:)]TJ ET EMC /P <>BDC BT 5 0 0 5 572.3109 58.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5 0 0 5 415.7711 51.456 Tm .03 Tw [(w)10(w)10(w)70.1(.)20(c)15.1(omet-initia)5.1(tiv)30(e)10(.)20(or)25.1(g/)30(S)5.1(tudies/Details/)-9.8(1838" \(A)10(ugus)10(t 20)10(21\))]TJ ET EMC /P <>BDC BT 5 0 0 5 568.701 51.456 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 5.5 0 0 5.5 415.7711 44.456 Tm ( )Tj ET EMC Q endstream endobj 283 0 obj <>/ExtGState<>>> endobj 295 0 obj <> endobj 300 0 obj <> endobj 305 0 obj <> endobj 294 0 obj <> endobj 311 0 obj <> endobj 316 0 obj <> endobj 321 0 obj <> endobj 310 0 obj <> endobj 333 0 obj <> endobj 338 0 obj <> endobj 332 0 obj <> endobj 350 0 obj <> endobj 355 0 obj <> endobj 360 0 obj <> endobj 349 0 obj <> endobj 370 0 obj <> endobj 375 0 obj <> endobj 369 0 obj <> endobj 389 0 obj <> endobj 394 0 obj <> endobj 388 0 obj <> endobj 412 0 obj <> endobj 417 0 obj <> endobj 411 0 obj <> endobj 429 0 obj <> endobj 434 0 obj <> endobj 428 0 obj <> endobj 440 0 obj <> endobj 445 0 obj <> endobj 439 0 obj <> endobj 456 0 obj <> endobj 461 0 obj <> endobj 466 0 obj <> endobj 454 0 obj <> endobj 476 0 obj <> endobj 481 0 obj <> endobj 475 0 obj <> endobj 489 0 obj <> endobj 494 0 obj <> endobj 488 0 obj <> endobj 503 0 obj <> endobj 508 0 obj <> endobj 513 0 obj <> endobj 501 0 obj <> endobj 523 0 obj <> endobj 528 0 obj <> endobj 522 0 obj <> endobj 538 0 obj <> endobj 543 0 obj <> endobj 537 0 obj <> endobj 293 0 obj <> endobj 550 0 obj <>stream /Artifact <>BDC q 1 i 0 841.89 595.275 -841.89 re 297.645 420.96 m W n .015015 841.89 595.29 -841.89 re W n 0 0 0 .08 k /GS1 gs .015015 0 595.26 841.89 re f EMC /P <>BDC BT /TT2 1 Tf 9 0 0 9 22.677 809.4763 Tm 0 0 0 .5 k 0 Tc .03 Tw [(Nutrino)30(v)30(o)0( | )]TJ ET EMC /P <>BDC /GS2 gs BT 9 0 0 9 81.5006 809.4763 Tm 0 0 0 1 k [(Pr)22.2(ot)15.1(ein Pr)22.2(o)30(vision in Critical Car)22.2(e)]TJ ET EMC /P <>BDC BT /F2 1 Tf 9 0 0 9 22.677 782.9969 Tm [(T)114(able 2: Out)15.1(c)15.1(ome measur)18.1(es r)18.1(ela)5.1(ting t)15.1(o)0( muscle w)20(a)0(s)10(ting, s)10(t)0(r)18.1(ength or ph)15.1(y)20(sical function tha)5.1(t ha)20(v)30(e)0( been pr)18.1(oposed )]TJ ET EMC /P <>BDC BT 9 0 0 9 22.677 770.9969 Tm [(f)10(or use in nutrition trials in critical car)18.1(e)]TJ ET EMC /Artifact <>BDC 0 0 0 .7 k /GS1 gs 22.677 744.769 85.487 17.678 re f EMC /P <>BDC BT 8 0 0 8 28.3464 751.0464 Tm 0 0 0 0 k -.0362 Tc [(Out)15.1(c)15.1(ome measur)18.1(e)]TJ ET EMC /Artifact <>BDC 0 0 0 .7 k 108.164 744.769 85.487 17.678 re f EMC /P <>BDC BT 8 0 0 8 113.8333 751.0464 Tm 0 0 0 0 k 0 Tc 0 Tw (Method)Tj ET EMC /Artifact <>BDC 0 0 0 .7 k 193.651 744.769 370.443 17.678 re f EMC /P <>BDC BT 8 0 0 8 193.6508 751.0464 Tm 0 0 0 0 k .03 Tw [(A)25.1(d)0(v)25.1(antages and disadv)25.2(antages)]TJ ET EMC /Artifact <>BDC 0 0 0 .2 k 22.677 635.286 85.487 109.483 re f EMC /P <>BDC /GS2 gs BT /TT2 1 Tf 7 0 0 7 28.3464 685.5326 Tm 0 0 0 1 k [(Muscle s)10(t)0(r)22.2(ength)]TJ ET EMC /P <>BDC BT 7 0 0 7 113.8333 734.6591 Tm 0 Tw (Handgrip)Tj ET EMC /P <>BDC BT 7 0 0 7 146.1383 734.6591 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 148.4483 734.6591 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 150.7583 734.6591 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 153.0683 734.6591 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 724.6591 Tm (dynamometry)Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 734.1691 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 734.1691 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 734.1691 Tm 0 0 0 1 k .03 Tw [(Needs s)10(t)0(r)25.1(ength and participa)5.1(t)15.1(or eff)10(ort t)15.1(o)0( hold dynamomet)15.1(er s)10(table)10(, but r)25.1(equir)25.1(es minimal pa)5.1(tient )]TJ ET EMC /P <>BDC BT 7 0 0 7 193.7548 724.1691 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 724.1691 Tm [(r)25.1(e-positioning.)]TJ ET EMC /P <>BDC BT 7 0 0 7 251.6228 724.1691 Tm ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 714.1691 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 714.1691 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 714.1691 Tm .03 Tw [(C)10(ontr)25.1(o)30(v)30(ers)15.1(y if hand grip s)10(t)0(r)25.1(ength is r)25.1(epr)25.1(esenta)5.1(tiv)30(e of o)30(v)30(e)0(r)25.1(all s)10(t)0(r)25.1(ength.)]TJ ET EMC /P <>BDC BT 7 0 0 7 443.2467 714.1691 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 704.1691 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 704.1691 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 704.1691 Tm .03 Tw [(V)70.1(aria)5.1(tion in method used mak)25.1(es c)15.1(omparison betw)25.1(een s)10(tudies difficult. R)10(equir)25.2(es s)10(tandar)25.1(dised appr)25.1(oach.)]TJ ET EMC /P <>BDC BT 7 0 0 7 560.4773 704.1691 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 694.1691 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 694.1691 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 694.1691 Tm .03 Tw [(Can be used t)15.1(o)0( identify ICU ac)10(quir)25.1(ed w)25.1(eaknes)10(s.)]TJ ET EMC /P <>BDC BT 7 0 0 7 367.1837 694.1691 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 7 0 0 7 113.8333 674.0118 Tm .03 Tw [(Medical R)10(esear)22.2(ch)]TJ ET EMC /P <>BDC BT 7 0 0 7 174.5498 674.0118 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 664.0118 Tm .03 Tw [(C)10(ouncil sum sc)15.1(or)22.2(e)]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 673.5217 Tm .34 1 .19 .01 k 0 Tw ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 673.5217 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 673.5217 Tm .03 Tw [(As)10(ses)10(ses s)10(t)0(r)25.1(ength, but pa)5.1(tients ma)20(y learn t)15.1(o)0( be functional in the absenc)15.1(e of s)10(t)0(r)25.1(ength.)]TJ ET EMC /P <>BDC BT 7 0 0 7 498.0888 673.5217 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 663.5217 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 663.5217 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 663.5217 Tm .03 Tw [(W)15.1(ith tr)25.1(aining, ph)15.1(y)20(sicians can gener)25.1(a)5.1(t)15.1(e highly r)25.1(epr)25.1(oducible r)25.1(esults.)]TJ ET EMC /P <>BDC BT 7 0 0 7 429.2749 663.5217 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 653.5217 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 653.5217 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 653.5217 Tm .03 Tw [(R)10(esults influenc)15.1(ed b)25.1(y)0( c)15.1(ognitiv)30(e dy)20(sfunction such as delirium.)]TJ ET EMC /P <>BDC BT 7 0 0 7 412.2076 653.5217 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 643.5217 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 643.5217 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 643.5217 Tm .03 Tw [(R)10(equir)25.1(es pa)5.1(tients t)15.1(o)0( be fully a)20(w)20(a)0(k)25.1(e)0( t)15.1(o)0( able t)15.1(o)0( participa)5.1(t)15.1(e)0( and f)10(ollo)25.1(w c)15.1(ommands. )]TJ ET EMC /Artifact <>BDC 0 0 0 .2 k /GS1 gs 22.677 283.191 85.487 350.095 re f EMC /P <>BDC /GS2 gs BT /TT2 1 Tf 7 0 0 7 28.3464 458.7436 Tm 0 0 0 1 k [(Muscle mas)10(s)]TJ ET EMC /P <>BDC BT 7 0 0 7 72.1242 458.7436 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 74.4342 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 76.7442 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 79.0542 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 81.3642 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 83.6743 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 85.9843 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 88.2943 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 90.6044 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 92.9144 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 95.2243 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 97.5343 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 99.8443 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 102.1545 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 104.4645 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 106.7745 458.7436 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 28.3464 448.7436 Tm .03 Tw [(or lean mas)10(s)]TJ ET EMC /P <>BDC BT 7 0 0 7 113.8333 623.6762 Tm 0 Tw [(C)10(omput)15.1(ed)]TJ ET EMC /P <>BDC BT 7 0 0 7 150.5823 623.6762 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 152.8923 623.6762 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 155.2023 623.6762 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 157.5123 623.6762 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 613.6762 Tm .03 Tw [(t)15.1(omogr)25.1(aph)15.1(y \()30(CT\))]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 623.1861 Tm .34 1 .19 .01 k 0 Tw ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 623.1861 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 623.1861 Tm 0 0 0 1 k .03 Tw [(Analy)20(sis of sk)25.1(eletal muscle in a single CT c)15.1(ould be carried out if pa)5.1(tient has alr)25.1(eady under)25.1(gone )]TJ ET EMC /P <>BDC BT 7 0 0 7 193.7548 613.1861 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 613.1861 Tm .03 Tw (abdominal CT scan, h)Tj 10.644 0 TD -.0261 Tc .0561 Tw [(oweve)-26.1(r)-26.1( r)]TJ 4.2504 0 TD 0 Tc .03 Tw [(outine use is difficult due t)15.1(o)0( c)15.1(o)0(s)10(t, time)10(, r)25.1(adia)5.1(tion e)30(xposur)25.1(e and risk of )]TJ ET EMC /P <>BDC BT 7 0 0 7 193.7548 603.1861 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 603.1861 Tm .03 Tw [(tr)25.1(ansporting acut)15.1(e pa)5.1(tients.)]TJ ET EMC /P <>BDC BT 7 0 0 7 297.8421 603.1861 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 593.1861 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 593.1861 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 593.1861 Tm 0 0 0 1 k .03 Tw [(R)10(educ)15.1(ed f)10(easibility f)10(or f)10(ollo)25.1(w up measur)25.1(ements in acut)15.1(e car)25.1(e pa)5.1(tients.)]TJ ET EMC /P <>BDC BT 7 0 0 7 445.3287 593.1861 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 583.1861 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 583.1861 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 583.1861 Tm 0 0 0 1 k .03 Tw [(Cut off points f)10(or lo)25.1(w sk)25.1(eletal muscle ar)25.1(ea as)10(socia)5.1(t)15.1(ed with mortality ha)20(v)30(e)0( been defined in ICU pa)5.1(tients.)]TJ ET EMC /P <>BDC BT 7 0 0 7 558.4279 583.1861 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 7 0 0 7 113.8333 563.5288 Tm .03 Tw [(Magnetic r)22.2(esonanc)15.1(e)]TJ ET EMC /P <>BDC BT 7 0 0 7 183.5858 563.5288 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 553.5288 Tm .03 Tw (imaging \(MRI\))Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 563.0388 Tm .34 1 .19 .01 k 0 Tw ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 563.0388 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 563.0388 Tm 0 0 0 1 k .03 Tw [(T)135(echnique is fr)25.1(ee of ionising r)25.1(adia)5.1(tion and c)15.1(ould allo)25.1(w pa)5.1(tient t)15.1(o)0( ha)20(v)30(e)0( r)25.1(epea)5.1(t)15.1(ed scans.)]TJ ET EMC /P <>BDC BT 7 0 0 7 498.5319 563.0388 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 553.0388 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 553.0388 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 553.0388 Tm 0 0 0 1 k .03 Tw [(Cannot be used if pa)5.1(tient has equipment tha)5.1(t cannot ent)15.1(er a magnetic field.)]TJ ET EMC /P <>BDC BT 7 0 0 7 465.9752 553.0388 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 543.0388 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 543.0388 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 543.0388 Tm 0 0 0 1 k .03 Tw [(Not useful if pa)5.1(tient cannot hold br)25.1(ea)5.1(th.)]TJ ET EMC /P <>BDC BT 7 0 0 7 340.8781 543.0388 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 533.0388 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 533.0388 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 533.0388 Tm 0 0 0 1 k .03 Tw [(Limit)15.1(ed t)15.1(o)0( use in highly specialised settings.)]TJ ET EMC /P <>BDC BT 7 0 0 7 354.291 533.0388 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 523.0388 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 523.0388 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 523.0388 Tm 0 0 0 1 k .03 Tw [(C)10(o)0(s)10(tly and r)25.1(equir)25.2(es specific )]TJ ET EMC /P <>BDC BT 7 0 0 7 299.7257 523.0388 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 7 0 0 7 113.8333 503.1315 Tm [(Musculosk)25.1(eletal)]TJ ET EMC /P <>BDC BT 7 0 0 7 168.5233 503.1315 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 493.1315 Tm [(ultr)25.1(asound )]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 502.6415 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 502.6415 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 502.6415 Tm 0 0 0 1 k .03 Tw [(R)10(ela)5.1(tiv)30(ely ine)30(xpensiv)30(e)10(,)0( but can be difficult t)15.1(o)0( ac)10(quir)25.1(e high quality images.)]TJ ET EMC /P <>BDC BT 7 0 0 7 455.7331 502.6415 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 492.6415 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 492.6415 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 492.6415 Tm 0 0 0 1 k .03 Tw [(Can \()30(only\) monit)15.1(or specific muscle gr)25.1(oups, ins)10(t)15.1(ead of whole body lean mas)10(s.)]TJ ET EMC /P <>BDC BT 7 0 0 7 468.4596 492.6415 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 482.6415 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 482.6415 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 482.6415 Tm 0 0 0 1 k .03 Tw [(Good int)15.1(er)75.2(/ intr)25.1(a observ)30(er r)25.1(eliability has been r)25.1(eport)15.1(ed.)]TJ ET EMC /P <>BDC BT 7 0 0 7 393.1573 482.6415 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 472.6415 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 472.6415 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 472.6415 Tm 0 0 0 1 k .03 Tw [(Muscle quality has been c)15.1(orr)25.1(ela)5.1(t)15.1(ed with muscle s)10(t)0(r)25.1(ength.)]TJ ET EMC /P <>BDC BT 7 0 0 7 398.864 472.6415 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 462.6415 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 462.6415 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 462.6415 Tm 0 0 0 1 k .03 Tw [(Lack of s)10(tandar)25.1(dised pr)25.1(ot)15.1(oc)15.1(ols.)]TJ ET EMC /P <>BDC BT 7 0 0 7 310.7979 462.6415 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 452.6415 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 452.6415 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 452.6415 Tm 0 0 0 1 k .03 Tw [(Influenc)15.1(ed b)25.1(y)0( oedema.)]TJ ET EMC /P <>BDC BT 7 0 0 7 280.6508 452.6415 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 442.6415 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 442.6415 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 442.6415 Tm 0 0 0 1 k .03 Tw [(Needs t)15.1(o)0( be es)10(tablished whether a change in muscle siz)15.1(e/)70.1(depth/)65.2(ar)25.2(ea can be tr)25.1(ansla)5.1(t)15.1(ed int)15.1(o a r)25.2(ele)25.2(v)25.1(ant )]TJ ET EMC /P <>BDC BT 7 0 0 7 193.7548 432.6415 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 432.6415 Tm .03 Tw [(clinical out)15.1(c)15.1(ome)10(.)]TJ ET EMC /P <>BDC BT 7 0 0 7 259.8609 432.6415 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 7 0 0 7 113.8333 411.7989 Tm [(Deut)15.1(er)25.1(a)5.1(t)15.1(ed)]TJ ET EMC /P <>BDC BT 7 0 0 7 152.8194 411.7989 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 155.1295 411.7989 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 157.4395 411.7989 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 159.7495 411.7989 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 162.0595 411.7989 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 164.3696 411.7989 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 166.6796 411.7989 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 168.9895 411.7989 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 171.2995 411.7989 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 173.6095 411.7989 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 401.7989 Tm [(cr)22.2(ea)5.1(tine )]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 411.3089 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 411.3089 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 411.3089 Tm 0 0 0 1 k .03 Tw [(Measur)25.1(es t)15.1(otal body cr)25.1(ea)5.1(tine pool siz)15.1(e)10(.)]TJ ET EMC /P <>BDC BT 7 0 0 7 336.977 411.3089 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 401.3089 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 401.3089 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 401.3089 Tm 0 0 0 1 k .03 Tw [(Can be as)10(ses)10(sed in lar)25.2(ge number of subjects with v)30(ery little subject bur)25.1(den.)]TJ ET EMC /P <>BDC BT 7 0 0 7 463.8406 401.3089 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 391.3089 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 391.3089 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 391.3089 Tm 0 0 0 1 k .03 Tw (Useful when CT or MRI cannot be used.)Tj ET EMC /P <>BDC BT 7 0 0 7 339.187 391.3089 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 381.3089 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 381.3089 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 381.3089 Tm 0 0 0 1 k .03 Tw [(L)10(e)0(s)10(s)0( influenc)15.1(ed b)25.1(y)0( obesity and aging.)]TJ ET EMC /P <>BDC BT /TT2 1 Tf 7 0 0 7 113.8333 362.2133 Tm [(Spot urine t)15.1(e)0(s)10(t)]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 361.7233 Tm .34 1 .19 .01 k 0 Tw ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 361.7233 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 361.7233 Tm .03 Tw [(A)25.1(dditional r)25.1(esear)25.2(ch r)25.2(equir)25.1(ed bef)10(or)25.1(e t)15.1(e)0(s)10(t)0( can be used clinically)85.2(.)]TJ ET EMC /P <>BDC BT /TT2 1 Tf 7 0 0 7 113.8333 343.0132 Tm (Urinary 3)Tj ET EMC /P <>BDC BT 7 0 0 7 145.7603 343.0132 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 333.0132 Tm [(meth)15.1(ylhis)10(tidine)10(,)]TJ ET EMC /P <>BDC BT 7 0 0 7 168.4742 333.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 170.7843 333.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 173.0941 333.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 175.4041 333.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 177.7142 333.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 323.0132 Tm (plasma)Tj ET EMC /P <>BDC BT 7 0 0 7 138.5712 323.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 140.8812 323.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 143.1914 323.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 145.5014 323.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 147.8112 323.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 150.1212 323.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 152.4312 323.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 154.7414 323.0132 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 313.0132 Tm [(phen)15.1(ylalanine)]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 342.5232 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 342.5232 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 342.5232 Tm .03 Tw [(Limit)15.1(ed intr)25.1(oduction int)15.1(o clinical pr)25.1(actic)15.1(e)10(.)]TJ ET EMC /P <>BDC BT 7 0 0 7 345.2368 342.5232 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 332.5232 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 332.5232 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 332.5232 Tm .03 Tw [(Pr)25.1(esenc)15.1(e of 3 meth)15.1(ylhis)10(tidine in the urine does not nec)15.1(es)10(sarily r)25.1(eflect the specific br)25.1(eak)25.1(do)25.1(wn of )]TJ ET EMC /P <>BDC BT 7 0 0 7 193.7548 322.5232 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 322.5232 Tm .03 Tw [(m)15.1(y)30(ofibrillar pr)25.1(ot)15.1(ein as it also r)25.1(eleased fr)25.1(om tis)10(sues other than sk)25.1(eletal muscle)10(.)]TJ ET EMC /P <>BDC BT 7 0 0 7 470.2346 322.5232 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 312.5232 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 312.5232 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 312.5232 Tm .03 Tw [(E)10(videnc)15.1(e sugges)10(ts plasma phen)15.1(ylalanine c)15.1(orr)25.1(ela)5.1(t)15.1(es w)25.1(ell with nitr)25.1(ogen balanc)15.1(e in burns pa)5.1(tients, )]TJ ET EMC /P <>BDC BT 7 0 0 7 193.7548 302.5232 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 302.5232 Tm .03 Tw [(but a)5.1(t)0( pr)25.1(esent ther)25.1(e is insufficient da)5.1(ta t)15.1(o)0( r)25.1(e)0(c)15.1(ommend its use as a r)25.1(eliable mark)25.1(er of pr)25.1(ot)15.1(ein turno)30(v)30(e)0(r)90.1(.)0( )]TJ ET EMC /P <>BDC BT 7 0 0 7 193.7548 292.5232 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 292.5232 Tm .03 Tw [(Obtained via art)15.1(erial punctur)25.1(e which is an in)20(v)25.1(asiv)30(e pr)25.1(oc)15.1(edur)25.2(e)10(.)]TJ ET EMC /P <>BDC BT 7 0 0 7 415.2355 292.5232 Tm 0 Tw ( )Tj ET EMC /Artifact <>BDC 0 0 0 .2 k /GS1 gs 22.677 162.396 85.487 118.795 re f EMC /P <>BDC /GS2 gs BT /TT2 1 Tf 7 0 0 7 28.3464 217.2986 Tm 0 0 0 1 k .03 Tw [(Ph)15.1(y)20(sical function)]TJ ET EMC /P <>BDC BT 7 0 0 7 113.8333 271.0811 Tm 0 Tw [(Six)30(-minut)15.1(e)]TJ ET EMC /P <>BDC BT 7 0 0 7 150.8062 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 153.1162 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 155.4262 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 157.7362 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 160.0462 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 162.3561 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 164.6662 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 166.9762 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 169.2863 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 171.5963 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 173.9063 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 176.2163 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 178.5263 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 180.8363 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 183.1463 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 185.4563 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 187.7663 271.0811 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 261.081 Tm .03 Tw [(w)20(alk t)15.1(e)0(s)10(t)0( )]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 270.5909 Tm .34 1 .19 .01 k 0 Tw ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 270.5909 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 270.5909 Tm 0 0 0 1 k .03 Tw [(Eas)15.1(y t)15.1(o)0( perf)10(orm, r)25.1(epr)25.1(oducible)10(, ine)30(xpensiv)30(e)10(.)]TJ ET EMC /P <>BDC BT 7 0 0 7 350.9774 270.5909 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 260.5909 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 260.5909 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 260.5909 Tm 0 0 0 1 k .03 Tw [(Can be difficult t)15.1(o)0( r)25.1(ecruit sufficient pa)5.1(tients tha)5.1(t ar)25.1(e able t)15.1(o)0( c)15.1(omplet)15.1(e the t)15.1(e)0(s)10(t)0( due t)15.1(o)0( impairment.)]TJ ET EMC /P <>BDC BT 7 0 0 7 540.0004 260.5909 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 250.591 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 250.591 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 250.591 Tm 0 0 0 1 k .03 Tw [(Can be time c)15.1(onsuming as t)15.1(e)0(s)10(t)0( r)25.1(equir)25.1(es 30 minut)15.1(e br)25.1(eak betw)25.1(een tw)25.1(o r)25.1(equir)25.1(ed t)15.1(e)0(s)10(ts.)]TJ ET EMC /P <>BDC BT 7 0 0 7 497.4529 250.591 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 7 0 0 7 113.8333 230.584 Tm .03 Tw [(Chelsea critical car)22.2(e)]TJ ET EMC /P <>BDC BT 7 0 0 7 183.7058 230.584 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 220.584 Tm .03 Tw [(ph)15.1(y)20(sical as)10(ses)10(sment)]TJ ET EMC /P <>BDC BT 7 0 0 7 184.154 220.584 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 210.584 Tm .03 Tw [(t)15.1(ool \()30(C)0(P)70.1(Ax\))]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 230.094 Tm .34 1 .19 .01 k 0 Tw ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 230.094 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 230.094 Tm 0 0 0 1 k .03 Tw [(Sc)15.1(or)25.1(e sho)25.1(w)15.1(s)0( s)10(t)0(r)25.2(ong as)10(socia)5.1(tions with hospital- dischar)25.1(ge des)10(tina)5.1(tion.)]TJ ET EMC /P <>BDC BT 7 0 0 7 441.7149 230.094 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 220.094 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 220.094 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 220.094 Tm 0 0 0 1 k .03 Tw [(Short time r)25.1(equir)25.1(ed f)10(or as)10(ses)10(sment, minimal use of equipment.)]TJ ET EMC /P <>BDC BT 7 0 0 7 419.0757 220.094 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 7 0 0 7 113.8333 191.2831 Tm .03 Tw [(Functional s)10(t)0(a)5.1(tus)]TJ ET EMC /P <>BDC BT 7 0 0 7 173.6403 191.2831 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 175.9504 191.2831 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 178.2604 191.2831 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 180.5704 191.2831 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 182.8804 191.2831 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 181.2832 Tm -.0215 Tc .0301 Tw [(sc)15.1(or)22.2(e f)10(or the int)15.1(ensiv)30(e)]TJ ET EMC /P <>BDC BT 7 0 0 7 187.8731 181.2832 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 171.2832 Tm .03 Tw [(car)22.2(e unity \(FFS-ICU\))]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 190.7932 Tm .34 1 .19 .01 k 0 Tw ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 190.7932 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 190.7932 Tm 0 0 0 1 k .03 Tw [(Has been sho)25.1(wn t)15.1(o)0( ha)20(v)30(e)0( s)10(t)0(r)25.1(ong int)15.1(er-observ)30(er r)25.1(eliability)85.2(.)]TJ ET EMC /P <>BDC BT 7 0 0 7 396.825 190.7932 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 180.7932 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 180.7932 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 180.7932 Tm 0 0 0 1 k .03 Tw [(Ability t)15.1(o)0( use in long t)15.1(erm f)10(ollo)25.1(w up ma)20(y be impact)15.1(ed b)25.1(y)0( c)15.1(eiling eff)10(ect.)]TJ ET EMC /P <>BDC BT 7 0 0 7 448.6468 180.7932 Tm 0 Tw ( )Tj ET EMC /Artifact <>BDC 0 0 0 .2 k /GS1 gs 22.677 49.44 85.487 110.956 re f EMC /P <>BDC /GS2 gs BT /TT2 1 Tf 7 0 0 7 28.3464 106.4232 Tm 0 0 0 1 k .03 Tw (Functional self)Tj ET EMC /P <>BDC BT 7 0 0 7 79.3062 106.4232 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 28.3464 96.4232 Tm [(sufficienc)5.1(y)]TJ ET EMC /P <>BDC BT 7 0 0 7 113.8333 149.2862 Tm .03 Tw (Barthel activities)Tj ET EMC /P <>BDC BT 7 0 0 7 172.1783 149.2862 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT 7 0 0 7 174.4884 149.2862 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 176.7983 149.2862 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 179.1083 149.2862 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 181.4184 149.2862 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 183.7284 149.2862 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 186.0383 149.2862 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 188.3483 149.2862 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 190.6583 149.2862 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 192.9684 149.2862 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 139.2862 Tm .03 Tw [(of daily living inde)30(x )]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 148.7962 Tm .34 1 .19 .01 k 0 Tw ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 148.7962 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 148.7962 Tm 0 0 0 1 k .03 Tw [(Risk of det)15.1(ection bias.)]TJ ET EMC /P <>BDC BT 7 0 0 7 278.5729 148.7962 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 138.7961 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 138.7961 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 138.7961 Tm 0 0 0 1 k -.0213 Tc .03 Tw [(Quick t)15.1(o)0( adminis)10(t)15.1(e)0(r)90.1(,)0( good r)25.1(eliability and v)25.1(alidity in s)10(t)0(r)25.1(o)0(k)25.1(e)0( pa)5.1(tients but t)15.1(e)0(s)10(ting is inc)15.1(onclusiv)30(e in ICU pa)5.1(tients.)]TJ ET EMC /P <>BDC BT 7 0 0 7 558.3386 138.7961 Tm 0 Tc 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 128.7962 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 128.7962 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 128.7962 Tm 0 0 0 1 k .03 Tw [(Can lack sensitivity t)15.1(o)0( clinically meaningful change in ICU pa)5.1(tients.)]TJ ET EMC /P <>BDC BT 7 0 0 7 432.1942 128.7962 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 7 0 0 7 113.8333 109.2893 Tm (Functional)Tj ET EMC /P <>BDC BT 7 0 0 7 150.4433 109.2893 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 99.2892 Tm [(independenc)15.1(e)]TJ ET EMC /P <>BDC BT 7 0 0 7 163.0213 99.2892 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 165.3314 99.2892 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 167.6413 99.2892 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 169.9514 99.2892 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 172.2614 99.2892 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 174.5714 99.2892 Tm ( )Tj ET EMC /P <>BDC BT 7 0 0 7 113.8333 89.2893 Tm [(measur)22.2(e )]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 108.7992 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 108.7992 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 108.7992 Tm 0 0 0 1 k .03 Tw [(As)10(ses)10(ses ph)15.1(y)20(sical and c)15.1(ognitiv)30(e disability)85.2(.)]TJ ET EMC /P <>BDC BT 7 0 0 7 346.2041 108.7992 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 98.7992 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 98.7992 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 98.7992 Tm 0 0 0 1 k .03 Tw [(Deriv)30(ed fr)25.1(om e)30(x)0(t)15.1(ensiv)30(e r)25.1(esear)25.1(ch with lar)25.1(ge sample siz)15.1(es.)]TJ ET EMC /P <>BDC BT 7 0 0 7 397.3504 98.7992 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 88.7992 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC BT 7 0 0 7 197.9548 88.7992 Tm ( )Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 202.1549 88.7992 Tm 0 0 0 1 k .03 Tw [(R)10(equir)25.1(es tr)25.1(aining t)15.1(o)0( ensur)25.1(e r)25.1(eliability)85.2(.)]TJ ET EMC /P <>BDC BT 7 0 0 7 329.4782 88.7992 Tm 0 Tw ( )Tj ET EMC /P <>BDC BT /TT2 1 Tf 7 0 0 7 113.8333 68.5423 Tm .03 Tw [(Quality of lif)10(e scales )]TJ ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 68.0523 Tm .34 1 .19 .01 k 0 Tw ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 68.0523 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 68.0523 Tm .03 Tw [(C)10(ould be influenc)15.1(ed b)25.1(y)0( e)25.1(v)30(ents oc)15.1(curring thr)25.1(oughout the pa)5.1(tient's lif)10(e)10(.)]TJ ET EMC /P <>BDC BT 7 0 0 7 442.5076 68.0523 Tm 0 Tw ( )Tj ET EMC /P <>BDC /GS1 gs BT /F2 1 Tf 7 0 0 7 193.6508 58.0523 Tm .34 1 .19 .01 k ()Tj ET EMC /P <>BDC /GS2 gs BT /F1 1 Tf 7 0 0 7 197.9548 58.0523 Tm 0 0 0 1 k ( )Tj ET EMC /P <>BDC BT 7 0 0 7 202.1549 58.0523 Tm .03 Tw [(Not y)30(et clear ho)25.1(w changes in these measur)25.1(es should be int)15.1(erpr)25.2(et)15.1(ed o)30(v)30(er long periods.)]TJ ET EMC /Artifact <>BDC 0 0 0 .5 K 0 J 0 j .5 w 10 M [] 0 d /GS1 gs q 1 0 0 1 108.164 684.372 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 684.372 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC 2 w q 1 0 0 1 22.677 634.286 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 108.164 634.286 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 634.286 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC .5 w q 1 0 0 1 108.164 573.889 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 573.889 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 108.164 513.492 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 513.492 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 108.164 422.159 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 422.159 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 108.164 372.073 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 372.073 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 108.164 354.373 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 354.373 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC 2 w q 1 0 0 1 22.677 282.191 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 108.164 282.191 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 282.191 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC .5 w q 1 0 0 1 108.164 240.944 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 240.944 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 108.164 202.643 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 202.643 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC 2 w q 1 0 0 1 22.677 161.396 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 108.164 161.396 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 161.396 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC .5 w q 1 0 0 1 108.164 120.149 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 120.149 cm 0 0 m 370.443 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 108.164 78.902 cm 0 0 m 85.487 0 l S Q EMC /Artifact <>BDC q 1 0 0 1 193.651 78.902 cm 0 0 m 370.443 0 l S Q EMC Q endstream endobj 551 0 obj <>/ExtGState<>>> endobj 6 0 obj <> endobj 5 0 obj <> endobj 191 0 obj <>stream Adobe d #"""#'''''''''' !! !!'''''''''' 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