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Table 1 The trial will use a 2 by 2 factorial design to test not only whether glutamine and selenium on their own are effective, but also whether there is extra effectiveness from the combination. For this reason allocation will be to one of four groups.

From: Randomised trial of glutamine and selenium supplemented parenteral nutrition for critically ill patients. Protocol Version 9, 19 February 2007 known as SIGNET (Scottish Intensive care Glutamine or seleNium Evaluative Trial)

  No glutamine Glutamine
No additional selenium Standard PN bag 12.5 g nitrogen, 2000 kcal daily PN bag, 12.5 g nitrogen (including 20.2 g glutamine), 2000 kcal daily
Additional selenium Standard PN bag 12.5 g nitrogen, 2000 kcal daily 500 μg selenium daily PN bag, 12.5 g nitrogen (including 20.2 g glutamine), 2000 kcal daily 500 μg selenium daily