Energy expenditure in the critically ill performing early physical therapy

Hickmann, C.; Roeseler, Jean; Castanares-Zapatero, Diego; Herrera, E.I.; Mongodin, A.; Laterre, Pierre‐François

doi:10.1007/s00134-014-3218-7

Cited by 56 publications

(36 citation statements)

References 36 publications

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“…Our study found that the baseline EE estimated by the Harris and Benedict formula 15 was significantly lower than that measured by IC. This finding corroborates the indication not to use this formula in critically-ill patients, 7,[16][17][18] and in patients with AKI. 19 The best way to assess the energy needs of critically-ill patients with AKI is by means of IC.…”

Section: Discussionsupporting

confidence: 85%

Daily variability of resting energy expenditure in acute kidney injury patients on dialysis

Góes¹,

Sanches²,

Balbi³

et al. 2017

Jornal Brasileiro De Nefrologia

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Variabilidade diária do gasto energético de repouso em pacientes com lesão renal aguda em tratamento dialítico Introdução: É imprescindível a correta estimativa do gasto energético de repouso (GER), que pode apresentar considerável variação diária no paciente crítico com lesão renal aguda (LRA). Objetivo: Avaliar a variabilidade diária do GER medido por calorimetria indireta (CI) em pacientes com LRA e indicação dialítica e identificar as variáveis clínicas associadas ao GER. Métodos: O GER foi medido no dia da indicação do procedimento dialítico e nos quatro dias subsequentes. Também foram avaliados parâmetros que podem influenciar o GER. As diferenças diárias foram analisadas pelo modelo linear generalizado para medidas repetidas, com distribuição gama, além da correlação de Spearman e regressão linear múltipla. Resultados: Foram 301 medidas de CI realizadas em 114 pacientes, com idade de 60,65 ± 16,9 anos e 68,4% do sexo masculino. O GER médio foi de 2081 ± 645 Kcal, com aumento no dia 5 (2270 ± 556 Kcal), quando comparado aos dias 2 e 3 (2022 ± 754; 2022 ± 660 kcal, respectivamente, p = 0,04); quando normalizado para peso, não houve diferença significante no GER (kcal/kg/dia) durante o acompanhamento. GER correlacionou-se positivamente com temperatura corporal, contagem total de leucócitos, proteína C reativa, volume minuto (VM), fração inspirada de oxigênio (FiO 2 ), aparecimento de nitrogênio ureico (UNA), peso corporal e estatura e inversamente com idade. Após a regressão linear múltipla, somente VM, FiO 2 e peso corporal e idade se correlacionaram independentemente. Conclusão: Pacientes com LRA dialíticos apresentam GER está-vel. O GER foi associado independentemente com FiO 2 , VM, peso e idade. Assim, requisitos ventilatórios precisam ser avaliados diariamente para que alterações necessárias na prescrição dietética sejam feitas. ResumoPalavras-chave: consumo de energia; lesão renal aguda; metabolismo energético. Introduction:It is needed for nutrition prescription correct estimate of resting energy expenditure (REE), which is a challenge given the possible daily variation in critically ill patients with acute kidney injury (AKI). Objective: To evaluate the daily variability of REE measured by indirect calorimetry (IC) in patients with AKI and dialysis indication and identify clinical variables associated with REE. Methods: The REE was measured on the time of dialysis indication and the subsequent four days. We also evaluated parameters that can influence the REE. The daily differences were analyzed by generalized linear model for repeated measures. We also used Spearman correlation and multiple linear regression. Results: There were 301 IC measurements in 114 patients, mean age of 60.65 ± 16.9 years and 68.4% were male. The average REE was 2081 ± 645 kcal, rising on day 5 (2270 ± 556 kcal) compared to the days 2 and 3 (2022 ± 754; 2022 ± 660 kcal, respectively, p = 0,04). When normalized to weight, there was no significant difference in REE (kcal/kg/day) during follow-up. REE was positively correlate...

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Section: Discussionsupporting

confidence: 85%

Daily variability of resting energy expenditure in acute kidney injury patients on dialysis

Góes¹,

Sanches²,

Balbi³

et al. 2017

Jornal Brasileiro De Nefrologia

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“…[16,[21][22][23][24] Of these 6 reports, there were 3 case series, [21][22][23] 1 case control study, [24] and 2 randomized clinical trials (RCTs), [16,20] with sample sizes varying from 16 [24] to 90 [16] enrolled patients. These reports included evaluation of single cycling sessions, [21][22][23] cycling as part of a rehabilitation therapy protocol, [20] cycling added to usual-care PT interventions, [16] and cycling augmented by electrical stimulation. [24] Reported cycling session duration was <5, [20,22] …”

Section: Discussionmentioning

confidence: 99%

Feasibility and safety of in-bed cycling for physical rehabilitation in the intensive care unit

Kho

Martin

Toonstra

et al. 2015

Journal of Critical Care

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“…However, this equation remained with poor degree of reproducibility (ICC 0.18), and poor agreement with IC (limits of agreement large, range -1,472 to 1,627.6 kcal/day). Other studies also showed low concordance and accuracy between the equation HB and IC, even using the injury factor [6,13,16,[33][34][35][36] .…”

Section: Discussionmentioning

confidence: 99%

Poor Agreement between Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Acute Kidney Injury Patients

Góes

Berbel-Bufarah²,

Sanches³

et al. 2016

Ann Nutr Metab

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Background: There are multiple equations for predicting resting energy expenditure (REE), but how accurate they are in severe acute kidney injury (AKI) patients is not clear. Our aim was to determine if predictive equations for estimated REE accurately reflect the requirements of AKI patients. Methods: We included in this prospective and observational study AKI patients AKIN-3 assessed by indirect calorimetry (IC). Bland-Altman, intraclass correlation coefficient and precision (percentagem of predicted values within 10% of measured values) were performed to compare REE by equations with REE measured by IC. Results: IC was applied in 125 AKI patients. The mean age was 62.5 ± 16.6 and 65.6% were male. Mean REE measured was 2,029.11 ± 760.4 kcal/day. There were low precision, and poor agreement between measured and predicted REE by the Harris-Benedict (HB), Mifflin, Ireton-Jones, Penn state, American College of Chest Physicians, and Faisy equations. HB without using injury factor was the least precise (18% of precision). Modified Penn state equation had the best precision, although the precision rate was only 41%. For all equations, the limits of agreement range were large leading to the potential under or overfeeding of individual patients. Conclusion: None of these equations accurately estimated measured REE in severe AKI patients and most of them underestimated energy needs.

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Energy expenditure in the critically ill performing early physical therapy

Cited by 56 publications

References 36 publications

Daily variability of resting energy expenditure in acute kidney injury patients on dialysis

Daily variability of resting energy expenditure in acute kidney injury patients on dialysis

Feasibility and safety of in-bed cycling for physical rehabilitation in the intensive care unit

Poor Agreement between Predictive Equations of Energy Expenditure and Measured Energy Expenditure in Critically Ill Acute Kidney Injury Patients

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