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

D. Clark Files, Timothy Heinrich, Katherine L. Shields, Nathan J. Love, Carly Brailer, Rita N. Bakhru, Lina Purcell, Lori Flores, Kevin Gibbs, Gary D. Miller, Peter E. Morris, Michael J. Berry

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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

Original languageEnglish
Pages (from-to)63-68
Number of pages6
JournalNitric Oxide - Biology and Chemistry
StatePublished - Jan 1 2020

Bibliographical note

Publisher Copyright:
© 2019 Elsevier Inc.


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

ASJC Scopus subject areas

  • Biochemistry
  • Physiology
  • Clinical Biochemistry
  • Cancer Research


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