Early Recovery Phase Research Articles

Recovery of autonomic function assessed by heart rate variability after stroke

Relevance: This paper is relevant to clinical research and practice. We evaluated autonomic function by sequential recording of heart rate variability (HRV) after stroke. The results were informative for the physical therapy after stroke, especially during early recovery phase.

Energization of outer radiation belt electrons during storm recovery phase

AbstractWe use test particle simulations incorporating an MHD model of ULF wave propagation in the magnetosphere with realistic ionosphere boundary conditions to study electron energization in the dayside outer Van Allen radiation belt, referenced to in situ particle and wave observations. On 7 January 2011 the THEMIS spacecraft detected 3 and 4–5 mHz waves simultaneous with flux enhancement of >10 keV electrons during the early recovery phase of a moderate geomagnetic storm. We find that internal energization of equatorially mirroring electrons via nonresonant ULF wave‐particle interactions can explain these observations. The wave poloidal components cause radial drift of electrons, increasing (decreasing) their kinetic energy as they move inward (outward). Electrons with initial kinetic energies of a few keV can be energized to double these values within an hour by interaction with the 3 mHz waves. The energization rate is somewhat less for the 4–5 mHz waves. An increase in the ionospheric conductance decreases the power of the fast mode wave, reducing radial drift velocities and hence decreasing the rate of energization. The fast mode poloidal field varies with radial distance and longitude, and this also affects energization. Electrons which drift outward encounter a region where the toroidal field due to the field line resonance becomes dominant and produces strong azimuthal drift. These electrons become trapped in an L‐shell range just outward of the resonance region and are not energized.

Supplemental Material for A Randomized Controlled Trial of Cognitive Remediation and Work Therapy in the Early Phase of Substance Use Disorder Recovery for Older Veterans: Neurocognitive and Substance Use Outcomes

Supplemental Material for A Randomized Controlled Trial of Cognitive Remediation and Work Therapy in the Early Phase of Substance Use Disorder Recovery for Older Veterans: Neurocognitive and Substance Use Outcomes

Examining the Predictors of Functional Independence and Discharge Destination of Patients with Stroke Post Hospital Discharge

To investigate patient characteristics, initial functional impairment, and stroke severity and effects on functional independence and discharge destination for patients with strokes through the early and post acute phase of recovery.

Intentional gaze shift to neglected space: a compensatory strategy during recovery after unilateral spatial neglect.

Unilateral spatial neglect is a common neurological syndrome following predominantly right hemispheric stroke. While most patients lack insight into their neglect behaviour and do not initiate compensatory behaviours in the early recovery phase, some patients recognize it and start to pay attention towards the neglected space. We aimed to characterize visual attention capacity in patients with unilateral spatial neglect with specific focus on cortical processes underlying compensatory gaze shift towards the neglected space during the recovery process. Based on the Behavioural Inattention Test score and presence or absence of experience of neglect in their daily life from stroke onset to the enrolment date, participants were divided into USN+‰‰+ (do not compensate, n = 15), USN+ (compensate, n = 10), and right hemisphere damage groups (no neglect, n = 24). The patients participated in eye pursuit-based choice reaction tasks and were asked to pursue one of five horizontally located circular objects flashed on a computer display. The task consisted of 25 trials with 4-s intervals, and the order of highlighted objects was randomly determined. From the recorded eye tracking data, eye movement onset and gaze shift were calculated. To elucidate the cortical mechanism underlying behavioural results, electroencephalagram activities were recorded in three USN+‰‰+, 13 USN+ and eight patients with right hemisphere damage. We found that while lower Behavioural Inattention Test scoring patients (USN+‰‰+) showed gaze shift to non-neglected space, some higher scoring patients (USN+) showed clear leftward gaze shift at visual stimuli onset. Moreover, we found a significant correlation between Behavioural Inattention Test score and gaze shift extent in the unilateral spatial neglect group (r = -0.62, P < 0.01). Electroencephalography data clearly demonstrated that the extent of increase in theta power in the frontal cortex strongly correlated with the leftward gaze shift extent in the USN+‰‰+ and USN+ groups. Our results revealed a compensatory strategy (continuous attention to the neglected space) and its neural correlates in patients with unilateral spatial neglect. In conclusion, patients with unilateral spatial neglect who recognized their own neglect behaviour intentionally focused on the neglected space as a compensatory strategy to avoid careless oversight.

Understanding patient and relative/carer experience of hip fracture in acute care: A qualitative study protocol

BackgroundThis paper presents a qualitative study protocol focusing on older peoples’ experience of recovery in acute care following hip fracture and also the experiences of their family or informal carers. There is limited evidence regarding older people and their relatives'/carers' experiences of recovery in acute care. AimThe study had two research questions. First what is the experience of older people who have suffered a fractured hip and secondly what is the relatives'/carers' experience of being alongside a person who has suffered a fractured hip? MethodsThe methodology chosen is phenomenology using the methods of interviewing and participant observation. It is planned to recruit a purposive sample of up to 40 patients including those with memory loss who have suffered a fractured hip, and up to 30 of their relative/carers, and up to 20 staff may choose to take part in the observation sessions. Analysis will be through drawing out units of meaning, bringing them together to form categories and themes of experience. ConclusionThis study will extend knowledge by exploring what is important to patients and their relatives/carers in the early phase of recovery. Practice based principles that can be integrated into the hip fracture pathway and enhance future care will be developed from the study findings.

Ionospheric effects of magnetospheric and thermospheric disturbances on March 17–19, 2015

Using vertical and oblique radio-sounding data, we analyze the ionospheric and thermospheric disturbances during the magnetic storm that occurred in northeastern Russia on March 17–19, 2015. We consider the heliospheric sources that induced the magnetic storm. During the main and early recovery phases, the midlatitude stations are characterized by extremely low values of electron density at the F2 layer maximum. Using oblique sounding data, we recorded signals that propagated outside the great circle arc. In evening and night hours, no radio signals were found to pass along the Norilsk–Irkutsk and Magadan–Irkutsk paths. The observed ionospheric effects are shown to be caused by a sharp shift of the boundaries of the main ionospheric trough to the invariant latitude 46° N during the main phase of the magnetic storm. The negative ionospheric disturbance during the recovery phase of the storm, which was associated with significant variations in the composition of the neutral atmosphere, led to a change in the mode composition of received radio signals and a decline in observed maximal frequencies in daytime hours of March 18, 2015 by more than 2 times.

Fuzzy Boundaries Between Post-Disaster Phases: The Case of L’Aquila, Italy

A number of indices have been developed for measuring vulnerability to disasters, but little attention has been paid to recovery indices. Post-disaster periods are usually divided into four phases. The terms established by the United Nations Development Programme for post-disaster phases—relief, early recovery, recovery, and development—are used in this article. This research examines the hypothesis that the boundaries between post-disaster recovery phases are fuzzy and should be defined by the progress achieved in the recovery process, rather than by the amount of time elapsed since the event. The methodology employed involved four steps: fieldwork, mapping, identification of indicators, and assessment. The case study area was the city of L’Aquila in the Abruzzo region of central Italy, which was struck by an earthquake in April 2009. For each phase of the recovery process in L’Aquila a score was calculated based on the progress observed in 2016, 7 years after the earthquake. The highest score went to the early recovery phase (14 points), followed by the recovery phase (13 points), the development phase (12 points), and the relief phase (4 points). The results demonstrate the possibility of defining post-disaster recovery phases in an affected area based on measuring achievements through indicators rather than defining recovery phases in terms of elapsed time after a disaster.

Introducing the Surgical Therapeutic Index in trauma surgery: an assessment tool for the benefits and risks of operative fracture treatment strategies

The Surgical Therapeutic Index (STI) has been described as an indicator of the benefits and risks of surgical treatment. The index is calculated by dividing the cure rate of an operative treatment by the complication rate. This study introduces the STI in trauma surgery by comparing the indices for surgical plate fixation (PF) and intramedullary fixation (IMF) of displaced midshaft clavicular fractures. In a previously reported, randomized controlled fashion, 120 patients were assigned to PF or IMF. Cure was defined by a Disabilities of the Arm, Shoulder and Hand score of 8 or less. Complications were noted as present or not present for each follow-up assessment, and a panel of experts provided weights to the severity of complications. STIs were reported along with their 95% confidence intervals. The higher a procedure's STI, the higher the benefit/risk balance of that procedure. The nonweighted STI after 6 weeks was significantly higher in the PF group. During further follow- up, the differences leveled out and became nonsignificant. When weighting the STI for severity, the indices decrease but are significantly in favor of the PF group at 6 weeks and 6 months after surgery. At 1 year postoperatively, differences are not significant. The STI may be a reliable tool to assess the benefits and risks of operative fracture treatment. Further studies with consistent results of this new scoring system are needed before conclusions can be generalized. When determining the indices of PF and IMF, a significant difference in favor of PF was observed during the early phase of recovery.

EP 6. Longitudinal resting state functional connectivity patterns in the early phase of recovery from Aphasia in temporoparietal stroke

Background Poststroke aphasia recovery evolves in space and time. Substantial language improvements can be observed within the first days after stroke. However, underlying changes in the functional status of the language network during the acute phase remain to be demonstrated. Methods In a resting-state functional connectivity (RSFC) fMRI study we assessed changes in functional connectivity repeatedly (acute( t 1) = 2 ± 1, subacute( t 2) = 10 ± 2 days post-onset) in aphasic patients ( N = 12, 62 ± 14 years, 10 male) with left temporoparietal stroke. Language comprehension and production scores were calculated based on the Aachener Aphasie-Test. For RSFC analysis 9mm spherical ROIs reflecting core language regions in the left anterior inferior frontal (aIFG: x = −54 y = 32 z = 1, MNI-space), posterior middle temporal gyrus (pMTG: x = −54 y = −43 z = 4) and their right hemisphere homologous were selected. Results Seed-to-whole-brain analysis from left aIFG or pMTG revealed RSFC to right hemisphere homologous frontal or temporal areas at t 1 and t 2 ( p > .05, FWE corrected). Longitudinally, RSFC from left pMTG to left aIFG as well as RSFC from left aIFG to left frontal (operculum, insula, premotor cortex) and to right frontal (IFG, premotor cortex) areas increased significantly from t 1 to t 2 ( p > .001, uncorrected). Subsequent ROI-to-ROI analysis revealed increased RSFC between left aIFG and pMTG from t 1 to t 2 associated with improved language production ( r = .579, p = .049). During the acute phase ( t 1) better scores for language comprehension and production were predicted by higher RSFC between left aIFG and right aIFG ( r = .736 p = .006). Conclusion We observed early ipsi- and contralesional changes in the language network’s functional connectivity and associated language improvements indicative of acute diaschisis and subsequent reorganization within the distributed language network.

FV 1. Perilesional activation in poststroke language recovery

Background Poststroke aphasia recovery evolves in time. Increased perilesional activity associated with treatment-related language improvements has been confirmed in the chronic phase ( Fridriksson et al., 2011 ), but has not yet been systematically demonstrated during the early phases of stroke recovery. The pathophysiology of stroke suggests that perilesional reorganisation evolves within days, lasting for months after stroke, while increased neuronal excitability might provide a basis for perilesional neuroplasticity ( Schiene et al., 1999 ). Methods We compared fMRI BOLD response to speech (SP) and reversed speech (REV) using an auditory comprehension paradigm ( Saur et al., 2006 ) administered repeatedly (acute (t1) ⩽ 1 week, subacute (t2) = 1–2 weeks, chronic (t3) > 6 months post-onset) to patients with stroke affecting left frontal (FC, N = 17) or temporoparietal cortex (TPC, N = 17). Language activation (SP > REV) obtained from three perilesional ROIs expanding stepwise to 39 mm beyond the lesion (DISTANCE) was compared across TIME and to the improvement of language comprehension/production. Results An ANOVA revealed a significant TIME × DISTANCE interaction (F(4) = 2.9, p = .025) with increased activation from t1 to t3 and t2 to t3 (p). Conclusion To conclude, a remapping of cortical language representations in undamaged left cortices is likely to commence during subacute phase of recovery and improvements of specific language functions differentially involve frontal or temporal perilesional areas.

Geomagnetic disturbance intensity dependence on the universal timing of the storm peak

AbstractThe role of universal time (UT) dependence on storm time development has remained an unresolved question in geospace research. This study presents new insight into storm progression in terms of the UT of the storm peak. We present a superposed epoch analysis of solar wind drivers and geomagnetic index responses during magnetic storms, categorized as a function of UT of the storm peak, to investigate the dependency of storm intensity on UT. Storms with Dst minimum less than −100 nT were identified in the 1970–2012 era (305 events), covering four solar cycles. The storms were classified into six groups based on the UT of the minimum Dst (40 to 61 events per bin) then each grouping was superposed on a timeline that aligns the time of the minimum Dst. Fifteen different quantities were considered: seven solar wind parameters and eight activity indices derived from ground‐based magnetometer data. Statistical analyses of the superposed means against each other (between the different UT groupings) were conducted to determine the mathematical significance of similarities and differences in the time series plots. It was found that the solar wind parameters have no significant difference between the UT groupings, as expected. The geomagnetic activity indices, however, all show statistically significant differences with UT during the main phase and/or early recovery phase. Specifically, the 02:00 UT groupings are stronger storms than those in the other UT bins. That is, storms are stronger when the Asian sector is on the nightside (American sector on the dayside) during the main phase.

Role of group 3 innate lymphoid cells during experimental otitis media in a rat model

The objective of this study was to evaluate the role of group 3 innate lymphoid cells (ILC3) in the middle ear (ME) mucosal response to bacterial infection in a rat model. To confirm the role of ILC3 in bacterially induced otitis media (OM), the serum concentrations of IL-17 and IL-22 were determined by ELISA, and the tissue expression of IL-17 and IL-22 in infected ME mucosa was assessed by immunohistochemical staining. Immunohistochemical staining of specific cell surface markers was also assessed to confirm the origin of the cells expressing IL-17 and IL-22. Twenty Sprague-Dawley rats were used in the surgically-induced animal model of OM. OM was induced by inoculation of non-typeable Haemophilus influenzae into the ME cavity of the rats. The rats were divided into four experimental groups: three infected groups and one control group. Infected groups were subdivided into sets of 5 rats, one for each of the three time points (1, 4 and 7 days post-inoculation). For determination of rat IL-17 and IL-22 levels in infected rats and control rats, infected or control ME mucosa sections were analyzed by immunohistochemistry with specific antibodies directed against IL-17 and IL-22. Immunohistochemical staining for CD3, RORγt, and NKp46 were also conducted on the samples to confirm the origin of cells expressing IL-17 and IL-22. IL-17 and IL-22 serum concentrations were significantly increased in the infected rats compared to control rats. Immunohistochemical staining revealed increased IL-17 and IL-22 expressions in all infected ME mucosae from the first day after inoculation. In addition, the results of tissue staining for the specific surface markers were negative for CD3 and NKp46, but were highly positive for RORγt. IL-17 and IL-22 revealed their association with the bacterially induced proliferative and hyperplastic responses of ME mucosa, which are characteristic features in pathogenesis of OM. Surface marker examination showed that the source cells for IL-17 and IL-22 seemed to be lymphoid tissue inducer (LTi) cells. The results suggest that LTi cells release IL-17 and IL-22, and play a significant role in both the early phase of OM induction and recovery from it.

Role of solar wind speed and interplanetary magnetic field during two-step Forbush decreases caused by Interplanetary Coronal Mass Ejections

The relationship of Forbush decreases (FDs) observed in Moscow neutron monitor with the interplanetary magnetic field (B) and solar wind speed (Vsw) is investigated in detail for the FDs associated with Interplanetary Coronal Mass Ejections (ICMEs) during 2001–2004. The classical two-step FD events are selected, and characteristics of the first step (mainly associated with shock), as well as of complete decrease (main phase) and recovery phase, are studied here. It is observed that the onset of FD occurs generally after zero to a few hours of shock arrival, indicating in the post-shock region that mainly sheath and ICME act as important drivers of FD. A good correlation is observed between the amplitude of B and associated FD magnitude observed in the neutron count rate of the main phase. The duration of the main phase observed in the neutron count rate also shows good correlation with B. This might indicate that stronger interplanetary disturbances have a large dimension of magnetic field structure which causes longer fall time of FD main phase when they transit across the Earth. It is observed that Vsw and neutron count rate time profiles show considerable similarity with each other during complete FD, especially during the recovery phase of FD. Linear relationship is observed between time duration/e-folding time of FD recovery phase and Vsw. These observations indicate that the FDs are influenced by the inhibited diffusion of cosmic rays due to the enhanced convection associated with the interplanetary disturbances. We infer that the inhibited cross-field diffusion of the cosmic rays due to enhanced B is mainly responsible for the main phase of FD whereas the expansion of ICME contributes in the early recovery phase and the gradual variation of Vsw beyond ICME boundaries contributes to the long duration of FD recovery through reduced convection–diffusion.

Cardiovascular and hemodynamic responses to adapted physical exercises in very old adults.

Aging is characterized by a physiological reduction in physical activity, which is inversely correlated with survival. Aim of the present study is to evaluate the cardiovascular, central hemodynamic and autonomic responses to a single bout of adapted physical exercise in octogenarian subjects. We studied cardiovascular, hemodynamic and autonomic responses to adapted physical activity in 33 subjects by a noninvasive methodology (Nexfin®, Edwards Lifesciences Corporation). Our octogenarians presented a significant increase in mean arterial pressure (p<0.01) and heart rate (p<0.005) in response to exercise, while both are reduced during the early recovery phase. Central hemodynamic showed a significant increase in stroke volume (p<0.05), cardiac output (p<0.01) and left ventricle contractility index (p<0.01), whereas systemic vascular resistance showed a significant decrease (p<0.001). We found a reduction in baroreflex control of the sinus node during exercise. Our data demonstrate that in very old people adapted physical activity is able to activate cardiovascular system and to induce a postexercise hypotension similarly to adults. The baroreflex control of sinus node seems to contribute in the physiological mechanism of these cardiovascular adaptations. In very old people, physical activity induces cardiovascular and hemodynamic responses not significantly different from those induced in adult even though some cautions particularly in the early recovery phase after exercise should be exercised.

Cognition in relation to independency in older, comorbid stroke patients in a stroke unit.

The objective of this study was to ascertain if cognition helps to predict functional outcome in older comorbid stroke patients with severe loss of independence. This is a cross-sectional study. The subjects of this study are patients who have suffered a stroke and who rehabilitated in the nursing homes' rehabilitation units and patients (n = 160) (mean age: 77; SD: 9.5) with a mean Barthel Index of 11.02. Demographic, illness-related, functional and cognitive data were selected at baseline. Functional abilities were tested using the Barthel Index. Cognitive functions were assessed using a wide variety of neuropsychological tests. Patients faced cognitive impairments especially in executive functioning and memory. Stepwise linear regression analysis shows that executive functioning (p = 0.050) and memory (p = 0.000; confidence interval -1.255, -0.403) are significantly associated with functional outcome. From a clinical point of view, we suggest combining physical and cognitive training from the very early phase of recovery.

Early Access to Vocational Rehabilitation for Inpatients with Spinal Cord Injury: A Qualitative Study of Patients' Perceptions.

Background: A pilot early-intervention vocational rehabilitation program was conducted in Sydney, Australia, over a 2-year period. It was postulated that the early provision of integrated vocational rehabilitation services in the hospital settings for newly injured individuals would be well received and result in better employment and psychosocial health outcomes. Objective: The objective of this qualitative inquiry was to examine the perspectives of program participants who had completed the intervention about the timeliness, perceived value, and critical elements of the early intervention. Methods: A convenience sample of participants was selected by accessibility; participants were interviewed individually after discharge using a semi-structured approach. Transcripts of the interviews were created via audio recordings; interviews were transcribed verbatim, and the contents were analyzed thematically. Results: Thirteen participants aged from 19 to 60 years with varying levels of impairment and vocational backgrounds were interviewed from 7 to 21 months post injury. Overall, the early introduction of vocational rehabilitation services was well received and viewed positively. Emerging themes include sense of direction and distraction, advocacy, and support, with "hope" (early after injury) emerging as the overarching theme. Criticisms voiced about the program were that it was offered too early in the intensive care unit and there were competing interests and information overload in the early recovery phase. Conclusions: Vocational rehabilitation provided during inpatient rehabilitation appears appropriate, important, and valuable from patients' perspective. Early engagement results in feelings of hope and encourages patients to see the possibility of returning to work or education very early after injury, and it allows rehabilitation to be directed accordingly.

Changing Brain Metabolism Patterns in Patients With ANMDARE: Serial 18F-FDG PET/CT Findings.

The aim of this study was to describe brain metabolic changing patterns demonstrated by serial brain FDG PET/CT scans and their relationship with the clinical course in patients with anti-N-methyl-d-aspartate receptor encephalitis (ANMDARE). Eighteen serial PET scans of 8 patients with ANMDARE were reviewed. All the 18 PET scans were divided into 4 groups according to studies timing in different clinical course: group A, the acute and subacute phase; group B, early recovery phase; group C, recovery phase; and group D, relapsing phase. Antibody levels of ANMDARE of all these patients were tested at the same time. The PET images of each group were analyzed visually and also compared with 10 age- and sex-matched normal controls using voxel-wise statistical parametric mapping analysis (SPM5). Variable brain metabolic patterns and its association with the clinical course and the levels of NMDA antibody were demonstrated by FDG PET images. First, severe hypometabolism in bilateral occipital lobes and relatively mild hypermetabolism in the partial frontal and basal ganglia in acute and subacute phase, the level of antibody was high. Second, in early recovery phase when the symptoms was partially improved, extensive cortical hypometabolism was observed, and the level of antibody was low. Third, the patients in the recovery phase have no obvious neurological and psychiatric symptoms; PET images were nearly normal, and the antibodies tests were all negative, correspondingly. Fourth, 3 scans of relapsing phase presented heterogeneous brain metabolic abnormalities. There existed a specific serial brain metabolic changing pattern that correlated with the clinical course and antibody level in ANMDARE.

POST-EXTINCTION BIOFACIES OF THE FIRST CARBONATE RAMP OF THE EARLY JURASSIC (SINEMURIAN) IN NE PANTHALASSA (NEW YORK CANYON, NEVADA, USA)

The end-Triassic mass extinction was global, severe, and accompanied by worldwide disturbance to carbonate ramp and platform sedimentation. We examine the earliest known Jurassic carbonate ramp produced in the back-arc basin along NE Panthalassa following the extinction event to determine the biotic constituents and timing of local ecological recovery. Field observations, fossil surveys, and microfacies analysis focused on the Ferguson Hill Member (Hettangian and Sinemurian) of the Sunrise Formation in the New York Canyon area of west central Nevada, USA. In the Hettangian, post-extinction biosiliceous sedimentation extended to the inner ramp, where an ooid and grapestone shoal marked the outermost extent of a narrow belt of carbonate sedimentation. An early recovery phase in the late Hettangian is characterized by widespread, laterally homogeneous, demosponge-dominated level-bottom sedimentation across the mid- to inner-ramp, in addition to limited trophic tiering (sessile epifaunal suspension feeding and mobile infaunal deposit feeding), substantial ramp aggradation, and poor settling conditions for competitive benthic colonizers (e.g., corals, crinoids, infaunal bivalves). Within 1.6–2 Myr after the extinction (in the early Sinemurian), a late recovery phase is recognized by the appearance of epifaunal grazers (gastropods, echinoids) and suspension feeders (crinoids, solitary scleractinian corals), phototrophic microbialites (oncoids, and possibly photosymbionts within corals), and infaunal deposit or suspension feeders (bivalves). Although the late recovery faunas included more trophic levels than pre-extinction carbonate ramp habitats, development and progradation of the first Jurassic carbonate ramp still relied heavily on sponge, microbialite, and abiotic mineralization.

Severely Compromised Anabolic Response to Nutrition in a Pseudomonas aeroginosa (PM) Induced Hyper‐dynamic Sepsis‐Recovery Pig Model

RationaleFeeding patients with sepsis is critical to restore muscle mass. However, it is unknown whether nutrition is able to induce an anabolic response during the early treatment phase of sepsis. We developed a reversible sepsis model in catheterized pigs by infusing live bacteria (PM) IV, followed by antibiotic induced recovery. We assessed the anabolic response to amino acid (AA) nutrition in the early recovery phase of sepsis using stable isotope methodology by measuring whole body protein synthesis (WbPS), protein breakdown (WbPB), net protein synthesis (netPS) and the efficiency of conversion of AA intake to protein (ProtConv).MethodIn 25 pigs (±25 kg), IV PM (3e8 CFU/ml/h) induced acute severe sepsis (n=13) or control IV solution (n=12) for 6 hours was followed by a single dose of gentamycine (5 mg/kg bw) and intra‐gastric constant continuous feeding with a dextrose containing AA mixture (pig muscle AA profile, 31 mg N/kg bw/h, 30% daily intake) for 6 hours. We measured WbPB, WbPS, net PS and ProtConv using primed, constant continuous intravenous infusion of Phenylalanine(ring‐2H5) and Tyrosine(13C9, 15N) stable isotopes and collected arterial blood samples between 9–12h. Enrichments of AA plasma pools were analyzed by LC‐MS/MS. Data are expressed as mean (SE) and stats by two‐way ANOVA or Student t‐test using Graphpad Prism6.ResultsIn the sepsis group during the AA nutrition intervention, WbPB rate was higher (p&lt;0.0001), netPS rate was lower (p&lt;0.0001), but no changes in WbPS (p=0.989). The ProtConv fraction was lower in the sepsis than in the control group (p&lt;0.0001). On average ProtConv was reduced with 43%: 65.1(3.6) vs 36.2(4.3)%, (p&lt;0.0001).ConclusionThe whole body anabolic response to AA nutrition is severely compromised in the early treatment phase of acute severe sepsis. Our innovative pig sepsis‐recovery model enables examination of the anabolic capacity of modified diets to restore sepsis induced muscle loss.Support or Funding InformationThis study was supported by NIH R01GM084447 and S10RR027047