Muscle growth and anabolism in intensive care survivors

INTERVENTION: Randomised controlled trial placebo versus nandrolone administration. Intervention arm: Nandrolone intramuscular injection (IMI) administered weekly for 3 weeks. Dose 50mg females, 100mg males Intervention will be administered by blinded investigators to inpatients so adherence will not be a problem. CONDITION: Diet and Nutrition ‐ Other diet and nutrition disorders Intensive Care;Critical illness myopathy;Critical illness nutrition; ; Intensive Care ; Critical illness myopathy ; Critical illness nutrition Musculoskeletal ‐ Other muscular and skeletal disorders Physical Medicine / Rehabilitation ‐ Other physical medicine / rehabilitation PRIMARY OUTCOME: Hospital length of stay (from medical records)[At hospital discharge] Time to walking with one person assisting (using the ICU mobility scale (IMS) ‐ from physiotherapy assessment)[Days from admission to ICU] SECONDARY OUTCOME: Change in muscle strength as measured by the medical research council muscle strength (MRC) sum score ‐ [Weekly from enrolment to hospital discharge ] Economic evaluation: Calculating difference between resource use and costs of total hospital stay from hospital medical records (including ICU length of stay)[At hospital discharge] Functional activity at hospital discharge, measured by Chelsea critical care assessment tool. [Hospital discharge] Functional assessment using SF 36[3 months following discharge] Grip strength measured by dynanometry[Weekly from enrolment to hospital discharge] ICU length of stay[ICU discharge] Time to return to work (for those working pre hospital)[Date of return to work (measured in days following hospital discharge)] INCLUSION CRITERIA: 1.) At least 21 years of age 2.) Admitted to participating ICU/HDU 3.) Receiving nutrition at estimated goals for at least 24 hours 4.) ICU/HDU length of stay => 5 days OR Significant weakness as deemed by treating clinician below patient’s baseline as a result of the ICU stay