Lead Sponsor

University of Vermont

Age

18 - No limit years

Sex

ALL

Healthy Volunteers

No

•1. \>=18 years old
•2. Requiring mechanical ventilation or high flow nasal cannula (HFNC) with actual or expected total duration of mechanical ventilation or HFNC \>48 hours
•3. Expected ICU stay \>4 days after enrollment (to permit adequate exposure to the proposed intervention)
•9. Pre-existing intracranial or spinal process affecting motor function
•10. Pre-existing cognitive impairment or language barrier that prohibits outcomes assessment
•11. Lower extremity impairments that prevent cycling (e.g. amputation, knee/hip injury)
•12. Weight \>150kg
•13. Pregnant
•14. Incarcerated

•1. \>120 continuous hours of mechanical ventilation or HFNC before enrollment
•2. Expected death or withdrawal of life-sustaining treatments within 7 days from enrollment
•3. No expectation for any nutritional intake within the subsequent 72 hours
•4. Severe chronic liver disease (MELD score \>20) or acute fulminant hepatitis.
•5. Documented allergy to the amino acid intervention
•6. Not ambulating independently prior to ICU admission (use of gait aid permitted)
•7. Pre-existing primary systemic neuromuscular disease (e.g. Guillain Barre)